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Table 13 Guidelines for contouring neck levels when negative at imaging in hypopharyngeal cancer

From: Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group

Site N stage Levels to be included Remarks
Pyriform sinus N0 IIa-IV bilateral V and RP bilateral, VI ipsilateral if oesophageal extension
Pyriform sinus N+ IIa-V-RP bilateral, VI ipsilateral Ipsilateral retrostyloid lymph nodes need to be included if clinical or radiological level II involvement is present.
Pharyngeal wall N0 IIa-IV-RP bilateral, VI ipsilateral V bilateral if esophageal extention
Pharyngeal wall N+ I-V, RP bilateral, VI ipsilateral Ipsilateral retrostyloid lymph nodes need to be included if clinical or radiological level II involvement is present.