Prevalence of intraparotideal lymph node metastases in primary parotid gland cancer and its prognostic value: A retrospective single center study

Introduction The aim of this retrospective cohort analysis was to evaluate the incidence of intraparotid lymph node (LK) metastases (P+) in primary parotid carcinoma and to analyze their prognostic value for oncologic outcome and survival.

Methods Patients with primary surgery for malignant parotid gland tumor (parotidectomy +/- neck dissection) at the ENT University Hospital of Cologne, which was carried out between 1990 and 2021, were identified. In addition to demographic data, clinical and oncologic characteristics were recorded and correlated with Disease-free (DFS) and overall survival (OS).

Results 188 patients were enrolled and followed up over a 63.2-month period. The most common entities were AdenoNOS (17.6%), MucoEp (14.9%), AdCC (14.4%) and AcinCC(12.8%). At least a subtotal parotidectomy was performed in 174 patients (93%). In total, mean of 5±5.0 intraparotid LK were removed, of which 0.5±1.8 had metastases (P+). from them, 3.5±3.9 LK were located in the superficial and 1.4±2 in the inner lobe. P+ were 0.4±1.6 (0-14) and 0.1±0.4 (0-3) LK, respectively. Overall icidence of P+ was 17.1%, mostly common in SalivDC (63.6%), AdenoNOS (36%), and SqCC (25%). Patients with SalivDC had a significantly higher incidence of P+ in the inner lobe (p=0.022). A 5-Year DFS in P+ patients was significantly shorter (34.2 months) compared to P- (45.4 months; p<0.001). Positive inner lobe metastases were associated with a shorter OS (p<0.004).

Conclusion Higher extent of parotidectomy is associated with a higher likelihood of capturing all intraparotid metastases, including those of the inner lobe. Especially for high-risk tumors, we recommend performing at least subtotal parotidectomy to improve overall survival.

Publication History

Article published online:
12 May 2023