Head/neck cancer: when should level IIb neck dissection be performed?

  • Hosokawa S & al.
  • World J Surg
  • 3 Sep 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Level IIb neck dissection in patients with head and neck squamous cell carcinomas (HNSCC) may only be required in cases with multilevel or level IIa metastasis or suspicious level IIb metastasis on preoperative exam.

Why this matters

  • Standard selective neck dissection with removal of level IIb nodes is associated with risk of damaging the spinal accessory nerve.

Key results

  • 10.34% of clinically node-positive necks had pathologically confirmed level IIb metastasis.
  • 0% of clinically node-negative necks had pathologically confirmed level IIb metastasis.
  • Clinically determined and pathologically confirmed level IIb nodal status were significantly correlated (P<.001>
  • 77.3% of patients developed shoulder abduction disorder and mitral muscle weakness following level IIb neck dissection.

Study design

  • 181 patients with HNSCC underwent level IIb neck dissection and were histopathologically examined.
  • Funding: None.

Limitations

  • Retrospective study.