title: Pathologic occult neck disease in patients with metastatic cutaneous squamous cell carcinoma to the parotid.
abstract: OBJECTIVE
  The aim of this study was to document the rate of pathologic neck disease in patients presenting with metastatic cutaneous squamous cell carcinoma (CSCC) to the parotid gland following parotidectomy and neck dissection in the clinically and radiologic negative neck.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  The study involved a retrospective chart review from 1999 to 2008 of patients presenting with metastatic CSCC to the parotid at the Princess Alexandra Hospital, Brisbane, Australia.
  
  
  RESULTS
  Eighty-one patients with metastatic parotid disease were identified. A total of 51 (63%) patients had no clinical or radiological evidence of cervical nodal disease. Forty-five patients (88%) were male, median age was 69 (range, 42-91) years, and the median follow-up was 16 (interquartile range, 9-44) months. Thirty-four of these patients underwent a parotidectomy and neck dissection with/without postoperative radiotherapy (RT). Occult pathological cervical nodal disease was found in 5 (14.7%) patients. Of those who received a neck dissection, 3 patients relapsed in the parotid, 1 in the neck alone, and 1 distantly.
  
  
  CONCLUSIONS
  This series has shown that the rate of pathologically involved neck nodes in patients with metastatic CSCC to the parotid in the clinically node negative neck is low. Given many of these patients warrant postoperative RT to the parotid bed, an elective neck dissection may not be warranted as the parotid and neck may be treated in continuity with RT.
authors.affiliation: Department of Otolaryngology Head & Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia. dianakirke@hotmail.com
authors.forename: Diana N
authors.initials: DN
authors.lastname: Kirke
authors.forename: Sandro
authors.initials: S
authors.lastname: Porceddu
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Wallwork
authors.forename: Benedict
authors.initials: B
authors.lastname: Panizza
authors.forename: William B
authors.initials: WB
authors.lastname: Coman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D012878:Skin Neoplasms / Q000473:pathology*