Feasibility and relevance of level I substation node counts in oropharyngeal carcinoma.

BACKGROUND The inclusion of level I in neck dissections for oropharyngeal carcinoma remains controversial. Our objectives were to evaluate the feasibility and relevance of substation node counts in level I of the neck dissection and to determine the specific substation location of metastases in level I in oropharyngeal carcinoma. METHODS Sixty specimens were retrospectively analyzed after an orientation using a new paradigm of demarcating level I specimens into 8 substations. RESULTS Three of the specimens (5%) in this study showed nodal metastasis in level I, one each in 3 different substations. All positive nodes in level I were associated with N+ disease in level II with 2 being radiographically occult (3.3%). Average total node count for level I was 8.1 (range, 2-19). CONCLUSION In oropharyngeal carcinoma, substation level I node quantification is feasible and relevant. This study shows a 5% risk to level I with metastasis in 3 different substations. © 2016 Wiley Periodicals, Inc. Head Neck 38:1194-1200, 2016.