Warshavsky A, et al. - To ascertain the rate of skip metastasis to neck level IV and to provide a high level of evidence, researchers conducted a study using meta-analysis in the patients with clinically node-negative neck (cN0) oral cavity squamous cell carcinoma (OCSCC). The involvement rate of level IV ranged between 0% and 11.40% in patients with cN0, whereas skip metastasis rate ranged between 0% to 5.50%. In cases including levels I through III, level IV skip metastasis rate did not rise significantly. The meta-analysis revealed that patients suffering from cN0 OCSCC, manifest very low rates of skip metastasis to neck level IV. Supraomohyoid neck dissection is necessary for patients with positive lymph nodes during neck dissection.