Abstract
Introduction
Survival significance of parotid lymph node (LN) factors in parotid cancer remains
unclear, our goal was to assess the impact of number, size, and extranodal extension
(ENE) of metastatic parotid LNs on prognosis in parotid cancer.
Materials and methods
Patients with surgically treated parotid cancer were retrospectively enrolled. Primary
outcome variable was recurrence-free survival (RFS) and overall survival (OS). The
hazard ratios (HRs) of main predictive variables including the number, size, and ENE
of positive parotid LNs on RFS and OS were analyzed using Cox model. The secondary
outcome variable was ENE of metastatic parotid LN, its association with clinicopathologic
variables were evaluated using Chi-square test.
Results
In total, 453 patients (186 male and 267 female) were included. The 10-year RFS and
OS rates were 73% (95%CI: 69%–77%) and 61% (95%CI: 55%–67%), respectively. In Cox
model, compared none parotid LN metastasis, one metastatic parotid LN did not offer
additional compromise of RFS (p = 0.224) or OS (p = 0.135), but two or more positive
LNs decreased the control of RFS (HR: 2.017; 95%CI: 1.378–4.632) and OS (HR: 2.173;
95%CI: 1.367–4.275). When accounting for the number of metastatic LNs, LN size or
ENE was no longer related to RFS or OS. ENE of parotid LN tended to develop if there
was presence of T3/4 stage, lymphovascular invasion, high histologic grade, N2/3 stage,
and three or more positive parotid LNs.
Conclusion
Quantitative parotid LN burden but not ENE or LN size is an important determinant
of survival in patients with parotid cancer.
Keywords
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Article info
Publication history
Published online: April 10, 2023
Accepted:
April 1,
2023
Received in revised form:
March 27,
2023
Received:
February 20,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
