Conclusion
We have demonstrated that level II, III and IV neck dissection is the
minimum number of levels required to be dissected for all patients
undergoing primary surgery for p16+ve OPSCC. Supra-selective ipsilateral
neck dissection in the primary surgical setting cannot be recommended
due to the potential risk of undertreatment of occult disease in level
IV. We also demonstrate that the cN0 neck at level II has a low negative
predictive value for the absence of clinical nodal disease at level II,
although the clinical utility of this is low.
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