title: Relevance of level IIb neck dissection in oral squamous cell carcinoma.
abstract: BACKGROUND
  The purpose of this study was to determine the prevalence of level IIb metastasis in patients with oral squamous cell carcinomas (OSCCs).
  
  
  METHODS
  A prospective analysis of 56 patients with OSCC who underwent surgical treatment of the primary lesion with simultaneous neck dissection was performed. During neck dissection, level IIb lymph nodes were separately removed and processed. Neck dissection was bilateral in 26 patients (46%) and unilateral in 30 patients (54%).
  
  
  RESULTS
  The mean number of nodes found in the level IIb specimens was 4.7 (range: 0-8 nodes). The prevalence of metastasis at level IIb was 0% in pN0 necks and 3.4% in pN+ necks, with an overall prevalence of 1.8%. A significant association between metastasis to level IIb and type of neck dissection was observed. There were no isolated metastases to level IIb without the involvement of other nodes in the remaining neck specimen. Four regional recurrences were observed during follow-up.
  
  
  CONCLUSIONS
  Based on our findings, we suggest that dissection of the level IIb region in patients with OSCC may be required only in patients with multilevel neck metastasis or if level IIa metastasis is found intraoperatively.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias, Faculty of Medicine, c/ Catedrático José Serrano s/n, 33006 Oviedo, Spain, jvicente@uniovi.es.
authors.forename: Juan-Carlos
authors.initials: JC
authors.lastname: de Vicente
authors.forename: Tania
authors.initials: T
authors.lastname: Rodríguez-Santamarta
authors.forename: Ignacio
authors.initials: I
authors.lastname: Peña
authors.forename: Lucas
authors.initials: L
authors.lastname: Villalaín
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Fernández-Valle
authors.forename: Manuel
authors.initials: M
authors.lastname: González-García
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection; D009367:Neoplasm Staging; D015995:Prevalence; D011446:Prospective Studies