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S007 Multi-institutional Prospective Study on the Prevalence of Sublevel IIB Metastases in Head and Neck Cancer

S007 Multi-institutional Prospective Study on the Prevalence of Sublevel IIB Metastases in Head... Objective: To evaluate the prevalence of sublevel IIB metastases and to identify patients in whom to avoid their dissection. Design: Multi-institutional prospective study. Setting: Two national cancer centers and 1 university hospital. Patients: Between 2002 and 2004, 340 patients were operated on the primary and/or the neck (499 neck dissections). The sites were oral cavity (n=120), larynx (n=106), oropharynx (n=50), thyroid (n=23), scalp (n=16), hypopharynx (n=12), unknown primary (n=7), and parotid (n=6). Interventions: Sublevel IIB lymph nodes (LNs) were separated from the others and processed apart. Main Outcome Measures: The influence of primary site, pT and pN status on the prevalence of sublevel IIB metastases was evaluated by χ2 test. Results: cN0/pN0 were 28%; cN+/pN+, 49%; cN+/pN0, 7%; and cN0/pN+, 16%. The overall prevalence of sublevel IIB metastases was 5.4%. All 3 patients (0.6% of the dissected neck sides) who were cN0/pN+ at sublevel IIB had advanced T stage. The χ2 test showed a higher risk for LN metastases at sublevel IIB in parotid, scalp, and unknown primary tumors if a 10% of probability of having positive LNs was chosen as the threshold limit (P<.001). The possibility of a cN0 neck with pN+ at sublevel IIB was lower than the probability of this finding in cN+ (P<.001). Conclusions: Sublevel IIB dissection is recommended for all cN+ patients and for those with parotid and scalp tumors, even if cN0. In all other settings, careful exploration of sublevel IIB should always be accomplished before avoiding its dissection. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

S007 Multi-institutional Prospective Study on the Prevalence of Sublevel IIB Metastases in Head and Neck Cancer

S007 Multi-institutional Prospective Study on the Prevalence of Sublevel IIB Metastases in Head and Neck Cancer

Abstract

Objective: To evaluate the prevalence of sublevel IIB metastases and to identify patients in whom to avoid their dissection. Design: Multi-institutional prospective study. Setting: Two national cancer centers and 1 university hospital. Patients: Between 2002 and 2004, 340 patients were operated on the primary and/or the neck (499 neck dissections). The sites were oral cavity (n=120), larynx (n=106), oropharynx (n=50), thyroid (n=23), scalp (n=16), hypopharynx (n=12), unknown primary (n=7),...
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Publisher
American Medical Association
Copyright
Copyright © 2006 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.132.8.839-b
Publisher site
See Article on Publisher Site

Abstract

Objective: To evaluate the prevalence of sublevel IIB metastases and to identify patients in whom to avoid their dissection. Design: Multi-institutional prospective study. Setting: Two national cancer centers and 1 university hospital. Patients: Between 2002 and 2004, 340 patients were operated on the primary and/or the neck (499 neck dissections). The sites were oral cavity (n=120), larynx (n=106), oropharynx (n=50), thyroid (n=23), scalp (n=16), hypopharynx (n=12), unknown primary (n=7), and parotid (n=6). Interventions: Sublevel IIB lymph nodes (LNs) were separated from the others and processed apart. Main Outcome Measures: The influence of primary site, pT and pN status on the prevalence of sublevel IIB metastases was evaluated by χ2 test. Results: cN0/pN0 were 28%; cN+/pN+, 49%; cN+/pN0, 7%; and cN0/pN+, 16%. The overall prevalence of sublevel IIB metastases was 5.4%. All 3 patients (0.6% of the dissected neck sides) who were cN0/pN+ at sublevel IIB had advanced T stage. The χ2 test showed a higher risk for LN metastases at sublevel IIB in parotid, scalp, and unknown primary tumors if a 10% of probability of having positive LNs was chosen as the threshold limit (P<.001). The possibility of a cN0 neck with pN+ at sublevel IIB was lower than the probability of this finding in cN+ (P<.001). Conclusions: Sublevel IIB dissection is recommended for all cN+ patients and for those with parotid and scalp tumors, even if cN0. In all other settings, careful exploration of sublevel IIB should always be accomplished before avoiding its dissection.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Aug 1, 2006

Keywords: head and neck cancer,neoplasm metastasis

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