Patterns of lymph node metastasis and the management of neck dissection for parotid carcinomas: a single-institute experience.
Adenocarcinoma
/ secondary
Adolescent
Adult
Aged
Aged, 80 and over
Elective Surgical Procedures
/ methods
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neck Dissection
/ methods
Neoplasm Recurrence, Local
/ pathology
Neoplasm Staging
Parotid Neoplasms
/ pathology
Retrospective Studies
Young Adult
Elective neck dissection
Histological grade
Lymph node metastasis
Occult metastasis
Parotid carcinoma
Journal
International journal of clinical oncology
ISSN: 1437-7772
Titre abrégé: Int J Clin Oncol
Pays: Japan
ID NLM: 9616295
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
16
12
2018
accepted:
31
01
2019
pubmed:
11
2
2019
medline:
28
7
2019
entrez:
11
2
2019
Statut:
ppublish
Résumé
There is no consensus about the indications and range of neck dissection in patients who have parotid carcinoma, with elective neck dissection for cN0 disease being particularly controversial. This study retrospectively reviewed 185 patients with newly diagnosed parotid carcinoma who were treated at our department between September 1999 and August 2018. 50 of the 185 patients had lymph node metastasis, including 7.7%, 12.2%, 36.0%, and 55.8% of patients with T1, T2, T3, and T4 disease, respectively. When classified by histological grade, 5.7% of patients with low/intermediate-grade disease had lymph node metastasis versus 55.0% of patients with high-grade disease. Multivariate analysis revealed that the histological grade and T classification were independent predictors of lymph node metastasis. Occult metastasis was found in 8 out of 73 clinically node negative patients undergoing neck dissection. The most common site of cervical metastasis was level 2, followed by the periparotid nodes, level 3, and level 4. Elective neck dissection may be most appropriate for parotid carcinoma patients with high grade disease and/or an advanced T classification. Because preoperative evaluation of the histological grade of parotid carcinoma has limited reliability, it is important to decide the indications and range of neck dissection from the results of frozen section biopsy.
Sections du résumé
BACKGROUND
BACKGROUND
There is no consensus about the indications and range of neck dissection in patients who have parotid carcinoma, with elective neck dissection for cN0 disease being particularly controversial.
METHODS
METHODS
This study retrospectively reviewed 185 patients with newly diagnosed parotid carcinoma who were treated at our department between September 1999 and August 2018.
RESULTS
RESULTS
50 of the 185 patients had lymph node metastasis, including 7.7%, 12.2%, 36.0%, and 55.8% of patients with T1, T2, T3, and T4 disease, respectively. When classified by histological grade, 5.7% of patients with low/intermediate-grade disease had lymph node metastasis versus 55.0% of patients with high-grade disease. Multivariate analysis revealed that the histological grade and T classification were independent predictors of lymph node metastasis. Occult metastasis was found in 8 out of 73 clinically node negative patients undergoing neck dissection. The most common site of cervical metastasis was level 2, followed by the periparotid nodes, level 3, and level 4.
CONCLUSION
CONCLUSIONS
Elective neck dissection may be most appropriate for parotid carcinoma patients with high grade disease and/or an advanced T classification. Because preoperative evaluation of the histological grade of parotid carcinoma has limited reliability, it is important to decide the indications and range of neck dissection from the results of frozen section biopsy.
Identifiants
pubmed: 30739264
doi: 10.1007/s10147-019-01411-3
pii: 10.1007/s10147-019-01411-3
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Pagination
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