Multivariate analysis of risk factors for neck metastases in surgically treated parotid carcinomas.
OBJECTIVE
To analyze risk factors for neck metastases in patients with parotid carcinomas.


METHODS
Cohort of patients followed up from 1 to 366.2 months at a single institution.


METHODS
Referral center, private or institutional practice, hospitalized care.


METHODS
A total of 145 patients with parotid carcinomas with complete clinical and pathological information. The histological diagnosis was reviewed according to the World Health Organization classification for salivary gland tumors.


METHODS
Patients were treated by surgery alone (62 cases) or with postoperative radiotherapy (83 cases). A neck dissection was performed in 80 patients.


METHODS
Rates of neck lymph node metastasis. Univariate and multivariate analyses were carried out using logistic regression evaluating the significance of demographic, clinical, and pathological data.


RESULTS
The following variables were significantly associated to the risk of lymph node metastasis by univariate analysis: histological type (P<.001), T stage (P<.001), desmoplasia (P = .001), facial palsy (P = .02), perineural invasion (P = .01), extraparotid tumor extension (P = .02), and necrosis (P = .003). By multivariate analysis, histological type (P<.001), T stage (P = .03), and desmoplasia (P = .006) had the highest correlation with lymph node metastasis.


CONCLUSIONS
The significant risk factors for neck metastasis in parotid carcinoma were histological type (ie, adenocarcinoma, undifferentiated carcinoma, high-grade mucoepidermoid carcinoma, squamous cell carcinoma, and salivary duct carcinoma), T stage (T3 and T4), and desmoplasia (severe).
Régis De Brito Santos
I
I
Medical School, University of São Paulo, Brazil.
Kowalski
L P
LP
Cavalcante De Araujo
V
V
Flávia Logullo
A
A
Magrin
J
J
D000230:Adenocarcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018277:Carcinoma, Mucoepidermoid / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D012307:Risk Factors