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Prevalence of nodal metastases in the submuscular recess (level IIb) during selective neck dissection.

Publication ,  Journal Article
Silverman, DA; El-Hajj, M; Strome, S; Esclamado, RM
Published in: Arch Otolaryngol Head Neck Surg
July 2003

OBJECTIVES: To determine the prevalence of nodal metastases in the submuscular recess (SMR) in patients undergoing selective neck dissection (SND) and to identify potential risk factors for the presence of metastatic disease in the SMR. DESIGN: Prospective cohort study. SETTING: Academic tertiary care referral center. PATIENTS: Consecutive patients undergoing SND for squamous cell carcinoma of the head and neck between January 5, 1998, and November 23, 2001, were prospectively analyzed. Patients with a history of neck dissection or whose pathology reports did not clearly distinguish the SMR from other nodal levels were excluded from the study. INTERVENTIONS: Patients underwent SND based on the primary tumor site and well established regional lymphatic drainage patterns.Main Outcome Measure Presence of histopathologically proven nodal disease in the SMR. RESULTS: Seventy-four patients underwent 90 SNDs, 16 of which were bilateral. The prevalence of metastases in the SMR was 1.6% (1/63) in clinically N0 necks and 11.1% (3/27) in clinically node-positive necks, with an overall incidence of 4.4% (4/90). There was a statistically significant association between SMR metastases and advanced pathologic N stage (P =.003), particularly with positive nodal disease in level IIa (P =.001). Extracapsular tumor spread was also shown to have a statistically significant association with metastases in the SMR (P =.01). No significant associations were observed between SMR metastases and primary tumor site (P =.06), clinical N stage (P =.09), a history of primary tumor recurrence (P =.52), or previous radiation therapy (P =.68). CONCLUSION: The results of the present study suggest that nodal metastases in the SMR are rare in head and neck cancer patients undergoing SND.

Duke Scholars

Published In

Arch Otolaryngol Head Neck Surg

DOI

ISSN

0886-4470

Publication Date

July 2003

Volume

129

Issue

7

Start / End Page

724 / 728

Location

United States

Related Subject Headings

  • Prospective Studies
  • Otorhinolaryngology
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lymph Node Excision
  • Humans
  • Head and Neck Neoplasms
  • Female
  • Carcinoma, Squamous Cell
 

Citation

APA
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ICMJE
MLA
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Silverman, D. A., El-Hajj, M., Strome, S., & Esclamado, R. M. (2003). Prevalence of nodal metastases in the submuscular recess (level IIb) during selective neck dissection. Arch Otolaryngol Head Neck Surg, 129(7), 724–728. https://doi.org/10.1001/archotol.129.7.724
Silverman, Damon A., Michel El-Hajj, Scott Strome, and Ramon M. Esclamado. “Prevalence of nodal metastases in the submuscular recess (level IIb) during selective neck dissection.Arch Otolaryngol Head Neck Surg 129, no. 7 (July 2003): 724–28. https://doi.org/10.1001/archotol.129.7.724.
Silverman DA, El-Hajj M, Strome S, Esclamado RM. Prevalence of nodal metastases in the submuscular recess (level IIb) during selective neck dissection. Arch Otolaryngol Head Neck Surg. 2003 Jul;129(7):724–8.
Silverman, Damon A., et al. “Prevalence of nodal metastases in the submuscular recess (level IIb) during selective neck dissection.Arch Otolaryngol Head Neck Surg, vol. 129, no. 7, July 2003, pp. 724–28. Pubmed, doi:10.1001/archotol.129.7.724.
Silverman DA, El-Hajj M, Strome S, Esclamado RM. Prevalence of nodal metastases in the submuscular recess (level IIb) during selective neck dissection. Arch Otolaryngol Head Neck Surg. 2003 Jul;129(7):724–728.

Published In

Arch Otolaryngol Head Neck Surg

DOI

ISSN

0886-4470

Publication Date

July 2003

Volume

129

Issue

7

Start / End Page

724 / 728

Location

United States

Related Subject Headings

  • Prospective Studies
  • Otorhinolaryngology
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lymph Node Excision
  • Humans
  • Head and Neck Neoplasms
  • Female
  • Carcinoma, Squamous Cell