Xiao R, Ward MC, Yang K, et al. - Researchers conducted a cohort study to examine the effect of level I lymph node involvement (LNI) on survival for patients with oropharyngeal squamous cell carcinoma (OPSCC). The study sample consisted of patients with OPSCC who had resection with known human papillomavirus (HPV) status in the National Cancer Database (2010-2014). Of the 5,591 OPSCC patients, 599 had level I LNI. pT classification, pN classification, and level III LNI were included predictors of level I LNI. Four thousand thirty-five had known survival status among patients included. According to subset analyses, a link was found between level I LNI and inferior OS among patients with base of tongue cancer, pT/pN classification greater than 1, and HPV-negative cancer. Overall, the authors concluded that level I LNI predicts inferior OS, especially in patients with at least pT2 or pN2 OPSCC.