IIb or not IIb: oncologic role of submuscular recess inclusion in selective neck dissections.
Bibliographic record
Abstract
OBJECTIVE: Selective neck dissections (SNDs) can yield outcomes that are oncologically similar to radical dissections but with less morbidity. The rate of metastasis to level IIb is not clear, and its dissection involves cranial nerve XI traction and devascularization, causing much morbidity. Our study examined the prevalence and predictors of cancer within the submuscular recess (SMR). METHODS: All SNDs performed by the authors were prospectively included from July 1, 2002, to March 31, 2006. Level IIb was sent as a distinct specimen. RESULTS: One hundred fifty-two dissections were performed. Only 12 (7.9%) were node positive in IIb. The SMR contained diseased nodes in 12.2% of N+ necks and 3.0% of N0 necks (p = .04); 23.1% (3 of 13) of laryngeal (1 of 8) and hypopharyngeal (2 of 5) tumours were node positive in IIb versus 6.4% in the oral cavity (p = .07) and 5.3% in oropharyngeal lesions. CONCLUSIONS: This is one of the largest prospective studies examining the role of level IIb dissection. It suggests that level IIb dissection might be unnecessary, especially in an N0 neck.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".