Related Experiment Video
Updated: Feb 3, 2026

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Distribution of Metastatic Nodes in N0-1 Patients with Tonsillar Squamous Cell Carcinoma and Its Implications for
Hugo Fontan Köhler1, Sérgio Altino Franzi1, Fernando Augusto Soares2
1Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Center, São Paulo, Brazil.
Objective:
We aimed to evaluate the pattern of neck metastasis in patients with primary tonsillar carcinoma treated by primary surgery and neck dissection. Impact of the extent of neck dissection and level of metastatic nodes on survival were also evaluated.
Methods:
We evaluated 163 consecutive patients with tonsillar squamous cell carcinoma submitted for neck dissection and staged as cN0-1. Selective neck dissection was performed using a template encompassing levels I-III, whereas radical neck dissection led to the removal at levels I-V. For each patient, number of metastatic nodes, their distribution, and data regarding postoperative treatment and oncologic outcomes were analyzed.
Results:
Occult neck metastasis at levels I, IV, and V were rare with two cases each. In the clinically negative (cN0) patients, there were no cases of metastasis at level V and two cases at level I or IV. The extent of neck dissection and level of metastatic nodes had no impact on disease-specific survival or neck recurrence.
Conclusion:
We conclude that in cN0 patients, removal at levels II and III is mandatory but levels I, IV, and V may be spared.
More Related Videos
Related Concept Videos
Pharmacokinetics in Pediatric Patients: Drug Distribution
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Muscles of the Anterior Neck
Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
Veins of Head and Neck
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...

