This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Which of the following levels of lymphnodes are first involved by papillary carcinoma? 
Select and explain. 
A. Level II, B. Level IV, C. Level V, D. Level VI
D: Level VI
Answer: D: Level VI 
Explanation: Pretracheal / Prelaryngeal are involved at First by papillary carcinoma of thyroid, which are Level VI neck lymph nodes.