Anatomic distribution of cervical lymph node spread in parotid carcinoma.
BACKGROUND
The pattern of distribution of cervical nodal involvement from primary parotid carcinomas has not been extensively described.


METHODS
All cases of parotid carcinoma over a 10-year period treated at our institution were reviewed. Data from the patients with cervical metastases were analyzed. These findings were pooled with previously published data on topography of cervical lymph nodes from parotid carcinomas.


RESULTS
Of 80 cases, 15 had cervical metastases (N+) in our series. When pooled with the data from all other reports, a total of 66 N+ cases were available for analysis. Twenty-eight percent of cases had involvement of level I, 59% had level II, 52% had level III, 38% had level IV, and 41% had level V. There were frequent skip metastases to level V but all were ipsilateral.


CONCLUSIONS
The diffuse distribution of cervical nodal metastases does not support a high echelon neck dissection or radiotherapy fields limited to the upper chain in the management of cervical nodal disease.
Chisholm
Edward J
EJ
Head and Neck Unit, Royal Marsden Hospital, London, UK. edwardchisholm@doctors.org.uk
Elmiyeh
Behrad
B
Dwivedi
Raghav C
RC
Fisher
Cyril
C
Thway
Khin
K
Kerawala
Cyrus
C
Clarke
Peter M
PM
Rhys-Evans
Peter H
PH
D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009333:Neck; D010307:Parotid Neoplasms / Q000473:pathology*