Work

Level IIb Metastases in cN0 Oral Squamous Cell Carcinoma: Multicenter Retrospective Study

Year: 2025

Type: article

Abstract: Importance Neck dissection is a common surgical treatment for patients with oral squamous cell carcinoma (OSCC). Due to the low incidence of level IIb metastases and the risk of injury to the spinal accessory nerve during level IIb dissection, the need for preventive neck dissection of this area has been discussed. Objective This study aimed to verify the incidence of level IIb metastases in patients with cN0 OSCC and to discuss the need for excision. Design Retrospective cohort study. Setting This study was conducted at 3 centers: the Department of Oral and Maxillofacial Surgical Oncology at the Institute of Science Tokyo Hospital, the Department of Oral and Maxillofacial Surgery at Kobe University Graduate School of Medicine, and the Department of Clinical Oral Oncology, Hokkaido Cancer Center. Participants In total, 222 patients with cN0 OSCC underwent supraomohyoid neck dissection (SOHND) between 2013 and 2021. Main Outcome Measures Incidence of level IIb metastases in patients with cN0 OSCC. Results Lymph node metastasis was confirmed in 57 patients (25.7%). Two patients (0.9%) had level IIb metastasis. The primary site in these cases was the tongue in 1 case and the lower gingiva in the other, both with advanced cT4 primary tumors. Isolated level IIb metastasis was observed in tongue OSCC samples. Both patients with level IIb metastases experienced primary recurrence. The 5 year overall survival rates for pN(−) and pN(+) patients were 80.6% and 74.3%, respectively ( P = .229). The 5 year disease-specific survival rates for the pN(−) and pN(+) patients were 89.6% and 77.2%, respectively ( P = .057). Conclusions and Relevance Level IIb lymph node involvement in clinical N0 neck cancers is rare. Thus, SOHND may be adequate for most patients with OSCC. Therefore, level IIb dissection may be omitted in patients with cN0 in early-stage OSCC.

Source: Journal of Otolaryngology - Head and Neck Surgery

DOI: 10.1177/19160216251349446

Authors: Takuma Kugimoto, Takumi Hasegawa, Takashi Niiyama, Masaya Akashi, Michihiro Ueda, Hiroyuki Harada

Institutions: Institute of Science Tokyo, Kobe University

Language: English

Topic: Head and Neck Cancer Studies

Subfield: Otorhinolaryngology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500