title: Predictors of nodal metastasis in salivary gland cancer.
abstract: OBJECTIVE
  This study was conducted to determine clinical and histologic factors that would predict nodal metastasis in patients with major salivary gland cancer.
  
  
  METHODS
  A retrospective study of 40 patients who underwent surgery, including neck dissection, for major salivary gland cancer between 1975 and 1997 was performed. Patient charts were reviewed, and clinical and pathologic data were extracted along with outcome. Predictive factors were identified and survival curves were obtained.
  
  
  RESULTS
  Neck dissections were performed in 40 patients, which revealed histologic evidence of tumor in lymph nodes in 15 cases. Histologically proven metastasis was found in 16% of specimens from elective and 73% of specimens from therapeutic neck dissection. Five-year overall and locoregional disease-free survival rates for histologically positive and negative groups were 40% versus 63% (P < 0.05) and 67% versus 69% (P = 0.59), respectively. Univariate analysis of the factors revealed that clinical evidence of nodal metastasis (P < 0.001) and high-grade cancer (P < 0.033) predicted histologic nodal involvement. Multivariate analysis revealed that only a positive neck examination was a significant predictive factor (OR = 31, 95%CI = 2.99-312).
  
  
  CONCLUSIONS
  Our results suggest that clinical neck examination is a reliable predictor of regional metastasis in patients with major salivary gland cancer. In view of the low frequency of occult metastases, routine elective treatment of the neck is not recommended.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Karmanos Cancer Institute Wayne State University, Detroit, Michigan 48201, USA.
authors.forename: Hakan
authors.initials: H
authors.lastname: Korkmaz
authors.forename: George H
authors.initials: GH
authors.lastname: Yoo
authors.forename: Wei
authors.initials: W
authors.lastname: Du
authors.forename: Eitan
authors.initials: E
authors.lastname: Hocwald
authors.forename: Jose E
authors.initials: JE
authors.lastname: Otero-Garcia
authors.forename: N
authors.initials: N
authors.lastname: Volkan Adsay
authors.forename: Terry
authors.initials: T
authors.lastname: Shibuya
authors.forename: John R
authors.initials: JR
authors.lastname: Jacobs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate