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  • Title: 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.
    Author: Hamoir M, Shah JP, Desuter G, Grégoire V, Ledeghen S, Plouin-Gaudon I, Rombaux P, Weynand B, Lengelé B.
    Journal: Head Neck; 2005 Nov; 27(11):963-9; discussion 969. PubMed ID: 16138365.
    Abstract:
    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.
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