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Johnson JT, Barnes EL, Myers EN, et al. The extracapsular spread of tumors in cervical node metastasis. Arch Otolaryngol 1981;107(12):725729 15. Byers RM, Weber RS, Andrews T, et al. Frequency and therapeutic implications of "skip metastases" in the neck from squamous carcinoma of the oral tongue. Head Neck 1997;19(1):14-19 16. Ha PK, Hdeib A, Goldenberg D, et al. The role of positron emission tomography and computed tomography fusion in the management of early-stage and advanced-stage primary head and neck squamous cell carcinoma.

Management of the Neck In patients that present with an NO neck after complete staging and with early-stage primary site disease, some type of treatment of the neck should be initiated in most cases. Most oropharyngeal primary sites, even at an early stage, will have a greater than 20% risk for metastasis. For this reason, in a patient who hopes to be treated with single-modality therapy, selective neck dissection of regions II, III, and IV at the very least should be employed. For unilateral lesions, such as tonsil, it would be appropriate to perform an ipsilateral selective neck dissection.

HA refers to lymph nodes anterior to the spinal accessory nerve. IIB refers to lymph nodes posterior to the spinal accessory nerve. (///) Level III lymph nodes are adjacent to the middle third of the internal jugular vein extending from the hyoid bone to the lower margin of the cricoid cartilage. The medial border is the lateral border of the sternohyoid muscle, and the posterior border is the posterior border of the sternocleidomastoid muscle. (IV) Level IV lymph nodes are located around the lower third of the internal jugular vein extending from the inferior border of the cricoid cartilage to the clavicle.

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A parametric empirical Bayes method for cancer screening using longitudinal observations of a biomar by Mcintosh M. W.


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