Occurrence of lymph node metastasis in early-stage parotid gland cancer |
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Authors: | Markus Stenner Christoph Molls Jan C Luers Dirk Beutner Jens P Klussmann Karl-Bernd Huettenbrink |
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Institution: | (1) Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany;(2) Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Giessen, Klinikstrasse 29, 35392 Giessen, Germany |
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Abstract: | Lymph node metastasis is one of the most important factors in therapy and prognosis for patients with parotid gland cancer.
Nevertheless, the extent of the primary tumor resection and the necessity of a neck dissection still is a common issue. Since
little is known about lymph node metastasis in early-stage parotid gland cancer, the purpose of the present study was to evaluate
the occurrence of lymph node metastases in T1 and T2 carcinomas and its impact on local control and survival. We retrospectively
analyzed 70 patients with early-stage (T1 and T2) primary parotid gland cancer. All patients were treated with parotidectomy
and an ipsilateral neck dissection from 1987 to 2009. Clinicopathological and survival parameters were calculated. The median
follow-up time was 51.7 months. A positive pathological lymph node stage (pN+) was found in 21.4% of patients with a significant
correlation to the clinical lymph node stage (cN) (p = 0.061). There were no differences in the clinical and histopathological data between pN− and pN+ patients. In 73.3% of
pN+ patients, the metastases were located intraparotideal. The incidence of occult metastases (pN+/cN−) was 17.2%. Of all
patients with occult metastases, 30.0% had extraparotideal lymphatic spread. A positive lymph node stage significantly indicated
a poorer 5-year overall as well as 5-year disease-free survival rate compared to pN− patients (p = 0.048; p = 0.011). We propose total parotidectomy in combination with at least a level II–III selective neck dissection in any case
of early-stage parotid gland cancer. |
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