Surgical treatment of the neck in patients with salivary gland carcinoma.
cervical lymph nodes
neck dissection
regional metastases
salivary gland carcinoma
surgery
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
21
01
2021
received:
23
09
2020
accepted:
19
02
2021
pubmed:
19
3
2021
medline:
1
7
2021
entrez:
18
3
2021
Statut:
ppublish
Résumé
Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines. Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method. Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases. We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.
Sections du résumé
BACKGROUND
Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines.
METHODS
Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method.
RESULTS
Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases.
CONCLUSION
We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1898-1911Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2021 Wiley Periodicals LLC.
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