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.
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.
Quantitative parotid LN burden but not ENE or LN size is an important determinant of survival in patients with parotid cancer.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Surgical Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Determining the number and distribution of intraparotid lymph nodes according to parotidectomy classification of European Salivary Gland Society: cadaveric study.Head Neck. 2020; 42: 3685-3692
- Patterns of lymph node metastasis and the management of neck dissection for parotid carcinomas: a single-institute experience.Int J Clin Oncol. 2019; 24: 624-631
- Evolution of head and neck cutaneous squamous cell carcinoma nodal staging-an Australian perspective.Cancers. 2022; 14: 5101
- Competing-risks nomograms for predicting cause-specific mortality in parotid-gland carcinoma: a population-based analysis.Cancer Med. 2021; 10: 3756-3769
- Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: systematic review.Head Neck. 2021; 43: 997-1008
- Significance of intraparotid node metastasis in predicting local control in primary parotid cancer.Laryngoscope. 2019; 129: 2309-2312
- The impact of nodal status in major salivary gland carcinoma: a multicenter experience and proposal of a novel N-classification.Oral Oncol. 2021; 112105076
- Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland.Head Neck. 2002; 24: 417-422
- Update from the 5th edition of the World Health organization classification of head and neck tumors: salivary glands.Head Neck Pathol. 2022; 16: 40-53
- Development of a novel salivary gland cancer lymph node staging system.Cancer. 2018; 124: 3171-3180
- Positive lymph node number and extranodal extension for predicting recurrence and survival in patients with salivary gland cancer.Head Neck. 2020; 42: 1994-2001
- Predictors of distant metastasis in parotid acinic cell carcinoma.BMC Cancer. 2019; 19: 475
- Oncologic outcome of parotid mucoepidermoid carcinoma in pediatric patients.Cancer Manag Res. 2019; 11: 1081-1085
- Value of lingual lymph node metastasis in patients with squamous cell carcinoma of the tongue.Laryngoscope. 2019; 129: 2527-2530
- Traditional risk factors and nodal yield-still relevant with high-quality risk-adapted adjuvant treatment for locally advanced head and neck cancer?.Strahlenther Onkol. 2022; https://doi.org/10.1007/s00066-022-02017-x
- High metastatic node number, not extranodal extension, as a node-related prognosticator in surgically treated patients with nodal metastatic salivary gland carcinoma.Head Neck. 2019; 41: 1572-1582
- Cervical lymph node metastatic status and adjuvant therapy predict the prognosis of salivary duct carcinoma.J Oral Maxillofac Surg. 2018; 76: 1578-1586
- Role of intra-parotid lymph node metastasis in primary parotid carcinoma.Life. 2022; 12: 2053
- Positive surgical margins in parotid malignancies: Institutional variation and survival association.Laryngoscope. 2019; 129: 129-137
- Margin status, local control, and disease-specific survival in surgically resected parotid carcinomas with parapharyngeal extension.Head Neck. 2021; 43: 2644-2654
Published online: April 10, 2023
Accepted: April 1, 2023
Received in revised form: March 27, 2023
Received: February 20, 2023
Publication stageIn Press Journal Pre-Proof
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.