title: Elective neck management for squamous cell carcinoma metastatic to the parotid area lymph nodes.
abstract: The objective of this study is to determine if radiotherapy (RT) alone to the cervical lymphatics is a suitable alternative to elective neck dissection (END) in patients who undergo parotidectomy and postoperative RT for squamous cell carcinoma metastatic to the parotid area lymph nodes (PALN). We retrospectively reviewed the medical records of 107 patients consecutively treated from November 1969 to March 2012 for cutaneous squamous cell carcinoma metastatic to the PALN with a clinically node-negative neck. Primary therapy consisted of parotidectomy in all cases. We compared regional (cervical) control in two subgroups: 42 patients treated with END and RT and 65 patients treated with elective neck irradiation (ENI) alone. The median time of follow-up was 5.5 years (range 0.3-30 years) for all patients and 11 years for living patients (range 1.8-26 years). There was 1 neck recurrence in each subgroup: END and RT, 1/42 (2 %); and ENI alone, 1/65 (1.5 %). No patient experienced a complication related to neck RT. ENI to a dose of approximately 50-60 Gy is a suitable alternative to END and postoperative RT in patients with squamous cell carcinoma metastatic to the PALN.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Herman
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amdur
authors.affiliation: Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Werning
authors.affiliation: Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Dziegielewski
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA. mendwm@shands.ufl.edu.
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D019468:Disease Management; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D010307:Parotid Neoplasms / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*
keywords: Head and neck; Lymph nodes; Parotid; SCCa