Frequency of histopathologically positive lymph nodes at level V in neck dissection of T3 and T4 oral squamous cell carcinoma

Objective: To determine the frequency of histopathologically positive lymph nodes at level V in neck dissection of T3 and T4 oral squamous cell carcinoma. Material and Methods: This prospective descriptive cross-sectional hospital-based study was conducted in the Department of ENT, head and neck surgery of Dow medical college, Dr. Ruth K.M Pfau Civil Hospital Karachi from 1st February to 30th August, 2021 A total of one hundred and fourteen (114) histopathologically proven cases of T3 and T4 oral squamous cell carcinoma were included in the study via non-probability consecutive sampling technique. The collected data was entered in SPSS version 26.0 for data analysis. Frequencies and percentages were calculated for qualitative variable, whereas, mean + SD for quantitative variables. Results: Postoperative analysis revealed positive neck nodes in 91 patients (79.8%), with metastasis observed at level I in 59 (51.8%), level II in 26 (22.8%), level III in 5 (4.4%), and level IV in 1 (0.9%) patient; none had level V involvement. Stratification by age, gender, tumor site, and cancer stage showed significant differences only for age and stage of the primary lesion. Conclusion: The findings of this study suggest that, oral SCC with T3–T4 lesions does not require level V neck dissection. However, given the small sample size, more research with a greater number of patients is necessary to develop future standards for the extent of neck node clearance in oral cancer Keyword: Level V neck dissection, Lymph nodes metastases, Oral squamous cell carcinoma