Evaluating the Necessity of Level IIb Dissection in Oral Squamous Cell Carcinoma: A Retrospective Cohort Study in an Iraqi Population

Section: Research Paper
Issue
Vol. 26 No. 2 (2026): Volume 26 Issue 2
Pages
508-525

Abstract

Aims: This study aimed to evaluate the necessity of level IIb dissection in patients within an Iraqi cohort.


Materials and Methods: The histopathological and clinical data of 50 patients with oral squamous cell carcinoma (29 males and 21 females), treated between June 2018 and June 2020, were analyzed. Histopathological studies were conducted on 857 lymph nodes, including 143 from level IIb, after immunohistochemical staining with cytokeratin 5/6. Statistical tests assessed predictors of level IIb involvement.


Results: Level IIb involvement was observed in only 2 cases (4%) with concurrent level IIa metastasis. No isolated level IIb involvement was detected. Primary tumor location (p =0.03) was a significant predictor of level IIb involvement. Other variables, such as age (p-value = 0.2675), sex (p-value = 0.503), grade (p-value = 0.1), DOI (p-value = 0.617), size (p-value = 0.319), and neck status (p-value =0.099), showed no significant association with level IIb involvement.


Conclusion: Routine dissection of level IIb is unnecessary in clinically negative oral squamous cell carcinoma cases and should be reserved for clinically positive or advanced diseases. Further studies incorporating advanced diagnostics are needed to refine clinical guidelines.

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Author

Sargon Shazo

Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Duhok, Duhok, Iraq

Identifiers

DOI: 10.33899/v8f4ae52

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