title: Interpretation of treatment outcome in the clinically node-negative neck in primary parotid carcinoma: a systematic review of the literature.
abstract: BACKGROUND
  Critical evaluation of outcome of primary parotid carcinoma treatment is limited by pathologic diversity and low incidence numbers. Scientific evidence for the optimal management of the N0-neck is scarce and was, therefore, investigated in a systematic literature review.
  
  
  METHODS
  The articles included were published in English between 1997 and 2007 and describe populations with the definitive pathology, staging, and treatment. Of 1104 articles, 19 were selected, describing 2703 patients.
  
  
  RESULTS
  Of eligible populations, 83% were clinically N0. Pathology reporting of elective lymph node dissection (ELND) had limitations, but 23% showed occult metastases. Regional recurrence occurred in 5% of patients.
  
  
  CONCLUSIONS
  The discrepancy between the relatively high percentage of occult metastases and reported low regional recurrence rates may indicate the efficacy of treatment, being either ELND or radiotherapy of the neck. Pooling, standardized collection, and reporting of data are essential in comparing outcomes in populations to determine optimal treatment.
authors.affiliation: Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Matthijs H
authors.initials: MH
authors.lastname: Valstar
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: Ludwig E
authors.initials: LE
authors.lastname: Smeele
mesh_terms: D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008197:Lymph Node Excision; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant