The incidence of level I metastasis in laryngopharyngeal squamous cell carcinoma

OBJECTIVES: We investigated the incidence of level I metastasis in patients with laryngeal and hypopharyngeal squamous cell carcinoma (SCC). PATIENTS AND METHODS: The records of 126 patients who underwent primary tumor excision with radical neck dissection (RND) or its modifications for laryngeal or hypopharyngeal SCC were retrospectively reviewed. Preoperative tumor and neck stages, the sites and the number of metastatic lymph nodes were recorded. Patients treated with selective neck dissection (SND) or preoperative chemotherapy and/or radiation therapy were excluded. RESULTS: Of 155 RND or modified RND performed for 113 laryngeal and 13 hypopharyngeal SCC, lymph node metastases were detected in 51 specimens, all of which spared level I. The most frequently involved levels were II and III. CONCLUSION: Selective neck dissection sparing level I may be appropriate for clinically and radiologically N0 patients with laryngopharyngeal carcinoma.