BACKGROUND: Supraglottic squamous cell carcinoma (SCC) is a significant portion of head and neck cancers, with the management of clinically negative necks (cN0) through selective neck dissection (SND) being debated due to potential morbidities and low metastasis rates in levels IIb and IV. METHODS: This study is a retrospective, multicenter examination of the potential feasibility of limited neck dissection (LND), including only levels IIa and III in cN0 supraglottic SCC patients. It analyzed occult metastasis rates and explored relapse occurrences alongside potential predictors of lymph node metastasis. RESULTS: Among 425 patients, predominantly male (85.6%) with a mean age of 63 years, the occult metastasis rate was 28.9%, and 13.7% experienced relapses during a mean follow-up of 52 months. Advanced clinical stage, higher grading, and other risk factors emerged as predictors of occult lymph node metastasis at level IIb. CONCLUSIONS: The study supports LND potential feasibility for cN0 supraglottic SCC, suggesting level IIb dissection can be omitted in specific early-stage cases to reduce morbidity without affecting outcomes.

Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy

Department of Biomedical Sciences Humanitas University Milan Italy

Department of Biomedical Sciences Humanitas University Milano Italy

Department of Experimental and Clinical Medicine University of Florence Florence Italy

Department of Head and Neck Surgery University of Sao Paulo School of Medicine Sao Paulo Brazil

Department of Head Neck and Sensory Organs Catholic University of the Sacred Heart Rome Italy

Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna Bologna Italy

Department of Medical Surgical and Health Sciences Section of Otolaryngology University of Trieste Trieste Italy

Department of Otolaryngology Head and Neck Surgery IRCCS Regina Elena National Cancer Institute Rome Italy

Department of Otolaryngology Head and Neck Surgery University Hospital of Modena Modena Italy

Department of Otorhinolaryngology Head and Neck Surgery IRCCS San Raffaele Scientific Institute Milan Italy

Department of Otorhinolaryngology Head and Neck Surgery University Hospital Ostrava and Faculty of Medicine Ostrava Czech Republic

Department of Sense Organs 'Sapienza' University of Rome Rome Italy

Department of Surgical and Medical Specialties Radiological Sciences and Public Health Unit of Otorhinolaryngology Head and Neck Surgery ASST Spedali Civili of Brescia Brescia Italy

Department of Surgical Sciences and Integrated Diagnostics University of Genova Genoa Italy

ENT Department University of Turin Head and Neck Cancer Unit San Giovanni Bosco Hospital Turin Italy

IRCCS Humanitas Research Hospital Milan Italy

Oncology Department University of Turin Italy

Otolaryngology and Audiology Unit IRCCS Azienda Ospedaliero Universitaria of Bologna Bologna Italy

Otolaryngology Head and Neck Surgery Department University of Verona Verona Italy

Otorhinolaryngology Unit A Gemelli University Hospital Foundation IRCCS Rome Italy

Otorhinolaryngology Unit IRCCS Humanitas Research Hospital Milan Italy

Unit of Otorhinolaryngology Head and Neck Surgery IRCCS Ospedale Policlinico San Martino Genoa Italy

Unit of Otorhinolaryngology Vittorio Veneto Hospital Vittorio Veneto Italy

Vita Salute San Raffaele University Milan Italy

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