title: Elective neck management for high-grade salivary gland carcinoma.
abstract: OBJECTIVE
  To determine whether patients with clinically node negative (cNo) high grade salivary gland carcinomas benefit from an elective neck dissection prior to postoperative radiotherapy (RT).
  
  
  METHODS
  Between October 1964 and October 2009, 59 previously untreated patients with cNo high-grade salivary gland carcinomas (squamous cell carcinomas were excluded) were treated with curative intent using elective neck dissection (END; n=41), or elective neck irradiation (ENI; n=18) at the University of Florida College of Medicine (Gainesville, FL). All patients underwent resection of the primary cancer followed by postoperative RT. The median follow-up period was 5.2years (range, 0.3-34years).
  
  
  RESULTS
  Occult metastases were found in 18 (44%) of the 41 patients in the END group. There were 4 recurrences (10%) in the END group and 0 recurrence in the ENI group. Neck control rates at 5years were: END, 90%; ENI, 100%; and overall, 93% (p=0.1879). Cause-specific survival was 94% in the ENI group, 84% in the END group, and 86% for all patients (p=0.6998). There were 3 reported grade 3 or 4 toxicities. Two patients had a postoperative fistula and one patient had a grade 4 osteoradionecrosis that required a partial mandibulectomy.
  
  
  CONCLUSIONS
  Patients with cNo high grade salivary gland carcinomas who are planned to undergo surgery and postoperative RT likely do not benefit from a planned neck dissection.
authors: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA.
authors: Michael P
authors: MP
authors: Herman
authors: John W
authors: JW
authors: Werning
authors: Christopher G
authors: CG
authors: Morris
authors: Jessica M
authors: JM
authors: Kirwan
authors: Robert J
authors: RJ
authors: Amdur
authors: William M
authors: WM
authors: Mendenhall
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000532:radiotherapy / Q000601:surgery; D018277:Carcinoma, Mucoepidermoid / Q000532:radiotherapy / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D055815:Young Adult