Cervical lymph node metastases: the significance of the level of the lymph node.

Two thousand and fifty-eight patients with squamous carcinoma of the head and neck are described. Thirty-five per cent of these patients had a node in the neck at the time of presentation. The level of the node was dictated by the primary tumour: other factors such as T or N status were not significant predictors of node level. Node level was a highly significant predictor of survival, together with age, general condition, node status and site the primary tumour. The 5-year survival for nodes at Level I (submandibular) nodes was 34%, and only 4% for nodes at Level IV.