Abstract
Oral squamous cell carcinoma （OSCC） often metastasizes to the cervical lymph nodes, but Level V metastasis is infrequent, and the prognosis of such cases is extremely poor. We describe the clinicopathological features of Level V metastasis in patients with OSCC.
Four （1.9%） of 212 patients who underwent radical or modified radical neck dissection had histopathologically confirmed Level V metastasis. The primary site was the tongue in 1 patient, the lower gingiva in 2 patients, and the oral floor in 1 patient. Level V metastasis was associated with the mode of invasion, but not with T stage. In the patients with Level V metastasis, the mean total number of involved nodes on the affected side was 18.8, and the mean rate of conversion to positive status of the cervical lymph nodes was 49%. As for metastatic features, all patients showed metastasis to lymph nodes in the Level II region. The treatment outcome of Level V metastasis was poor, and all patients died of disease with a mean survival time of 9.3 months after neck dissection. In conclusion, although the frequency of Level V metastasis in oral squamous cell carcinoma was low, the prognosis was extremely poor. Furthermore, lymph-node metastases and extracapsular invasion in other regions appeared to be associated with Level V metastasis.
