CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S369
DOI: 10.1055/s-0038-1640996
Poster
Speicheldrüsen/Schilddrüsen: Salivary Glands/Thyroid Gland

Occult cervical and intraglandular nodal involvment in parotid malignancy – Incidence and therapeutic implications

K Dahlem
1   Hals-, Nasen-, Ohrenklinik Freiburg, Freiburg
,
J Pfeiffer
2   Uniklinik Freiburg, Freiburg
,
C Becker
2   Uniklinik Freiburg, Freiburg
› Author Affiliations
 

Introduction:

The incidence of occult cervical lymph node metastases varies highly in malignant tumors of the parotid gland. The aim of the study was to evaluate the incidence of occult metastases (cervical and intraglandular) and the outcome of elective neck dissection (END) in the clinically normal lymphonodal status.

Methods:

Retrospective Analysis of 102 patients with a malignant tumor of the parotid gland, treated from 2002 – 2016 at our tertiary clinic. Staging of nodal involvement was carried out by ultrasound and in most cases by CT scan. Endpoints were overall- and disease free survival.

Results:

Of 102 patients 54 presented with a cN0 status. 96 patients were treated primarily surgically. END was performed in advanced tumor stage (cT3/cT4). There were no occult metastases. Overall survival (p = 0,438) and disease free survival (p = 0,532) showed no significant difference with and without END.

High grade tumors (p = 0,001) and perineural- as well as lymphovascular infiltration (p < 0,001) significantly correlated with cervical lymphonodal involvment.

Intraglandular lymphonodal involvement were present in 13 cases (11 high grade tumors) which was only revealed after completing total parotidectomy in 5 cases.

Discussion:

The Incidence of cervical lymphnode involvement was surprisingly low in this study. Hence END should only be performed in locally advanced tumors as well as high grade tumors. Complementary total parotidectomy is, due to the rate of intraglandular nodal involvement, suggested in small but high grade tumors. Evidence of intraglandular nodal involvement does have an impact on total outcome and further treatment.



Publication History

Publication Date:
18 April 2018 (online)

© 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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