title: Clinical significance of intraparotid lymph node metastasis in primary parotid cancer.
abstract: BACKGROUND
  The clinical utility of intraparotid lymph node metastasis in primary parotid cancer is unknown, and this study was undertaken to address this gap in knowledge.
  
  
  METHODS
  A medical chart review was performed on 86 patients who underwent parotidectomy with neck dissection (39 cN+ and 47 cN0). The disease-specific mortality and locoregional recurrence (LRR) were correlated with intraparotid lymph node metastasis status.
  
  
  RESULTS
  Using intraparotid lymph node metastasis status to predict cervical nodal metastasis resulted in a sensitivity and specificity of 70% and 90.6%, respectively (positive predictive value [PPV] of 87.3%). Patients with positive intraparotid lymph node metastasis had a worse 3-year disease-specific mortality compared with patients with negative intraparotid lymph node metastasis (p = .0037). Patients with cN0 neck but positive intraparotid lymph node metastasis were more likely to develop locoregional recurrence than patients without intraparotid lymph node metastasis (p = .08).
  
  
  CONCLUSIONS
  In patients with cN0 neck but positive intraparotid lymph node metastasis, intraparotid lymph node metastasis presence was strongly associated with a worse disease-specific survival and placed them at a higher risk of locoregional recurrence.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania; Department of Otolaryngology Head and Neck Surgery, National University Health System, Singapore.
authors.forename: Chwee Ming
authors.initials: CM
authors.lastname: Lim
authors.forename: Mark R
authors.initials: MR
authors.lastname: Gilbert
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
authors.forename: Seungwon
authors.initials: S
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D010307:Parotid Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: clinical significance; intraparotid lymph node metastasis; nodal metastasis; primary parotid cancer