title: Implications of intraglandular lymph node metastases in primary carcinomas of the parotid gland.
abstract: OBJECTIVE
  Assess the diagnostic and prognostic relevance of intraglandular lymph node (IGLN) metastases in primary parotid gland carcinomas (PGCs).
  
  
  METHODS
  Retrospective study at a tertiary referral university hospital.
  
  
  METHODS
  We reviewed the records of 95 patients with primary PGCs, treated at least surgically, between 1997 and 2010. We assessed the clinicopathological associations of IGLN metastases, their prognostic significance, and predictive value in the diagnosis of occult neck lymph node metastases
  
  
  RESULTS
  Twenty-four (25.26%) patients had IGLN metastases. This feature was significantly more prevalent in patients with advanced pT status (P = .01), pN status (P < .01), and overall stage (P < .001); high-risk carcinomas (P = .01); as well as in patients with treatment failures (P < .01). IGLN involvement was significantly associated with decreased univariate disease-free survival (P < .001). Positive and negative predictive values and accuracy for IGLN involvement in the detection of occult neck lymph node metastases were 63.64%, 90.48%, and 84.91%, respectively. The diagnostic values were generally higher in patients with low-risk subtype of PGCs.
  
  
  CONCLUSIONS
  IGLN involvement provides prognostic information and is associated with advanced tumoral stage and higher risk of recurrence. This feature could be used as a potential readout to determine whether a neck dissection in clinically negative neck lymph nodes is needed or not.
  
  
  METHODS
  4.
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.|Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.|Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Lluís
authors.initials: L
authors.lastname: Nisa
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Salmina
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.|Institute of Pathology, University of Bern, Bern, Switzerland.
authors.forename: Matthias Stephan
authors.initials: MS
authors.lastname: Dettmer
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Arnold
authors.affiliation: Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.|Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Daniel Matthias
authors.initials: DM
authors.lastname: Aebersold
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Borner
authors.affiliation: Department of Otorhinolaryngology-Head & Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Giger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Parotid gland cancer; intraglandular lymph node metastasis; neck dissection; neck lymph node metastasis; prognostic factors