Publication Type:

Journal Article


Otolaryngology - Head and Neck Surgery (United States), Volume 147, Number 2, p.275-277 (2012)



80 and over, adult, aged, article, cancer chemotherapy, cancer incidence, cancer localization, cancer radiotherapy, cancer recurrence, cancer staging, cancer surgery, Carcinoma, cervical lymph node, disease severity, female, follow up, human, Humans, lymph node metastasis, Lymphatic Metastasis, major clinical study, male, medical record review, metastasis, middle aged, neck cancer, neck dissection, neck metastasis, Neoplasm Staging, pathology, primary tumor, Retrospective Studies, retrospective study, review, skip metastasis, Squamous Cell, squamous cell carcinoma, tertiary health care, tongue carcinoma, Tongue Neoplasms, tongue tumor, university hospital


Objective. Nodal metastasis from oral tongue squamous cell carcinoma follows a predictable pattern. Isolated level IV involvement, termed skip metastases, is described. This study attempts to identify the incidence of skip metastasis. Study Design. Case series with chart review. Setting. Tertiary academic hospital. Subjects. Fifty-two consecutive patients with T1 to T4 N0 stage who underwent excision of the primary tumor with neck dissection (levels I-IV). Methods. Retrospective study. The incidence of isolated level III or IV involvement pathologically and isolated nodal recurrence in levels III and IV was analyzed. Results. Pathologically, isolated level III involvement occurred in 2 (3.8%) patients. Isolated level IV occurred in 1 (1.9%) patient. Mean follow-up was 24 months. Two patients had recurrence in the primary site; 1 had recurrence in neck level II. None had recurrence in level III or IV. Conclusion. Skip metastasis is rare in T1 and T2 oral tongue squamous cell carcinoma. Inclusion of level IV is not mandatory in selective neck dissection for clinically and radiologically negative neck disease in early tumors (T1 and T2). © 2012 American Academy of Otolaryngology - Head and Neck Surgery Foundation.


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Cite this Research Publication

Da Balasubramanian, Thankappan, Ka, Battoo, A. Ja, Rajapurkar, Ma, Kuriakose, M. Ab, and Iyer, Sa, “Isolated skip nodal metastasis is rare in T1 and T2 oral tongue squamous cell carcinoma”, Otolaryngology - Head and Neck Surgery (United States), vol. 147, pp. 275-277, 2012.