A prospective analysis of prevalence of metastasis in levels IIB and V neck nodes in patients with operable oral squamous cell carcinoma

Abstract Objectives The present study was designed to know and analyze the prevalence of pathological involvement of level IIB and V neck nodes in operable oral cavity squamous cell carcinomas. Materials and methods All treatment naive, willing biopsy proven patients of age group 18–70 years with oral cavity squamous cell carcinomas undergoing surgery from May 2015 to December 2016 in a single tertiary care Institute were prospectively analyzed for level IIb and V involvement. Results A total of 199 patients met the selection criteria of the study. Most common site was buccal mucosa, majority were cT2 lesions and 90% underwent Modified neck dissection. 63% of patients had pN0 disease. The rate of involvement of level II b and V nodes was 3% and was associated with higher T size, disease burden in proximal basin and lymphovascular invasion. There was no skip metastasis to level IV. Only one patient had skip metastasis to levels V and IIB each. Conclusion To conclude our data strongly supports omission of level IIb and level V nodal dissection routinely in patients with cT1 and T2 buccal cancers. However, a randomized controlled study to evaluate the morbidity as well as recurrence pattern between the selective and super-selective approach is warranted.