Relevance of oropharyngeal cancer lymph node metastases in the submandibular triangle and the posterior triangle apex.

BACKGROUND Neck dissection of levels I and IIB is time consuming and can cause several comorbidities. The aim was to analyze whether levels I and IIB need to be dissected in patients with oropharyngeal cancer and clinical N0 or N+ neck. PATIENTS AND METHODS A retrospective analysis of 77 patients with oropharyngeal cancer was carried out with evaluation of the incidence of neck node metastasis in levels I and IIB. RESULTS None of the patients with cN0 neck had metastases in level I or IIB; 12.8% of the patients with cN+ neck had metastases in level I, 35.1% in level IIA and 25.6% had metastases in level IIB. CONCLUSION Levels I and IIB should be dissected in cN+ neck in order to achieve maximal oncological safety. The preservation of levels I and IIB in cN0 neck seems to be justified in terms of improving functional results and concomitant reduction of operation time.