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Prevalence of lymph nodes in the apex of level V: a plea against the necessity to dissect the apex of level V in mucosal head and neck cancer

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Hamoir, Marc [UCL] Shah, Jatin P Desuter, Gauthier [UCL] Grégoire, Vincent [UCL] Ledeghen, Stéphane [UCL] Plouin-Gaudon, Isabelle [UCL] Rombaux, Philippe [UCL] Weynand, Birgit [UCL] Lengelé, Benoît [UCL]

BACKGROUND: We assessed the prevalence of histologically proven normal or invaded lymph nodes in the apex of level V. METHODS: Seventy neck dissections were performed in 41 patients with mucosal head and neck squamous cell carcinoma (SCC). Fifty-one neck dissections were performed in 30 previously untreated patients (group 1); 19 neck dissections were carried out in 11 patients previously irradiated (group 2). RESULTS: Pathologic analysis was unable to identify any lymph node in 70% of the apex specimens. In group 1, no lymph nodes were detected in 63%, whereas one or more noninvaded lymph nodes were present in 37%; in group 2, no lymph nodes were identified in 89%, whereas one or more normal lymph nodes were found in 11% (p = .03). Metastatic lymph nodes were never identified. CONCLUSIONS: The prevalence of lymph nodes in the apex was 30%. No invaded lymph nodes were identified. In addition to anatomic evidence, these results suggest that dissection of the apex is not necessary in mucosal head and neck SCC.

Document type Article de périodique (Journal article) – Article de recherche – Journal Article
Access type Accès libre
Publication date 2005
Language Anglais
Journal information "Head & Neck : journal for the sciences and specialities of the head and neck" - Vol. 27, no. 11, p. 963-969; discussion 969 (2005)
Peer reviewed yes
Publisher JohnWiley & Sons, Inc. ((United States) Hoboken)
issn 1043-3074
e-issn 1097-0347
Publication status Publié
Affiliations UCL - MD/NOPS - Département de neurologie et de psychiatrie
UCL - MD/MNOP - Département de morphologie normale et pathologique
UCL - (SLuc) Service de chirurgie plastique
UCL - (SLuc) Service d'oto-rhino-laryngologie
MESH Subject Carcinoma, Squamous Cell - pathology - surgery ; Head and Neck Neoplasms - pathology - surgery ; Humans ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Neck Dissection ; Neoplasm Staging ; Prevalence ; Prospective Studies
Keywords Head and neck cancer ; Lymph nodes ; Neck dissection ; Squamous cell carcinoma ; Neck metastases
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Bibliographic reference Hamoir, Marc ; Shah, Jatin P ; Desuter, Gauthier ; Grégoire, Vincent ; Ledeghen, Stéphane ; et. al. Prevalence of lymph nodes in the apex of level V: a plea against the necessity to dissect the apex of level V in mucosal head and neck cancer. In: Head & Neck : journal for the sciences and specialities of the head and neck, Vol. 27, no. 11, p. 963-969; discussion 969 (2005)
Permanent URL http://hdl.handle.net/2078.1/25022