Study Indicates Dissection of Level IIb in LSCC Generally Unnecessary

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(Chemotherapy Advisor) – A team of researchers in Turkey have found that dissection of the level IIb area in patients with laryngeal squamous cell carcinoma (LSCC) may not always be necessary. This is based on a clinical study recently published in the March issue of Otolaryngology—Head and Neck Surgery.

In this study, entitled “The Necessity of Dissection of Level IIb in Laryngeal Squamous Cell Carcinoma: A Clinical Study”, the authors initially establish that there is a dilemma in whether or not to remove the level IIb area when performing neck dissection surgery in patients with LSCC that has metastasized into the adjacent cervical lymph nodes, as this is a common occurrence in this patient population. The aim of the study was to define the frequency of level IIb metastasis to lymph nodes in patients who had previously undergone selective neck dissection because of LSCC.

Eighty-one LSCC patients were selected for this study. From these patients, 148 neck dissection tissue samples were examined histopathologically to identify those with level IIb metastasis; six percent of the patients had level IIb metastasis. The tissue samples were labeled clinically N+ or N-; other parameters included primary tumor site, central tumor presence, and T stage.

The relationship between level IIb metastasis and clinical N stage, as well as the other parameters in the study, was not found to be statistically significant (P ≥ .05).

The authors concluded that “level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve.”


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