Background: The dissection of level V neck lymph nodes often results in a decline of postoperative quality of life due to shoulder dysfunction and pain. The necessity of level V dissection is debatable. The aim of the present study was to evaluate the prevalence of level V metastases in patients with node-positive squamous cell carcinomas of the head and neck.
Patients and methods: A review of the clinical and pathological reports was conducted to ascertain the prevalence and distribution of cervical metastases according to neck level V. Statistical analysis was performed using Fisher's exact test.
Results: Level V metastases were found in 19 out of 104 (18.3%) patients. There was only one patient with level V metastases without involvement of other levels. There was no statistically significant correlation between level V lymph node metastasis and several clinical factors.
Conclusion: It seems to be feasible to omit dissection of level V in patients without clinical evidence for level V disease without compromising oncological safety.