title: Probability and pattern of occult cervical lymph node metastases in primary parotid carcinoma.
abstract: The present study was undertaken to evaluate real probability and pattern of cervical occult lymph node metastases (OLNM) in primary parotid carcinoma (PPC). We carried out a retrospective analysis of 66 patients treated in years 1992-2010 due to PPC, who underwent elective neck dissection (END). In search of risk factors for OLNM, we analysed the following parameters: age, sex, pT-Status, tumour size, skin invasion, facial nerve palsy, tumour fixation, extraparotid extension, localization, grade, histology, intra/periparotid LN metastases (IPLNM). OLNM was observed in 30.3% of patients. In a univariate analysis statistical significance was found for IPLNM, extraparotid extension and high risk histology. A multivariate analysis showed statistical significance only for the first variable. The most common location of cervical OLNM was level II (80%), then III (45%) and V (30%). In a compilation of our own material with data from the literature (5 series), we obtained a group of 80 patients with OLNM, selected out of 650 patients with cN0 (12.3%). The proportion of metastases to particular levels was the following: 69%-II, 22.5%-III, 20%-I,16%-V, 7.5%-IV. END should be carried out in case of all T3/T4a carcinomas with minimal range of levels II and III. Removal of levels Ib and Va is recommended as well. In the T1/T2 carcinomas with high grade/high risk histology, END should be performed including levels II and III.
authors.affiliation: Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland. dstodulski@gumed.edu.pl.
authors.forename: Dominik
authors.initials: D
authors.lastname: Stodulski
authors.affiliation: Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Bogusław
authors.initials: B
authors.lastname: Mikaszewski
authors.affiliation: Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Majewska
authors.affiliation: Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Wiśniewski
authors.affiliation: Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Czesław
authors.initials: C
authors.lastname: Stankiewicz
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006258:Head and Neck Neoplasms / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: Cervical; Elective neck dissection; Lymph node groups; Lymph node metastases; Occult; Parotid carcinoma; Regional