Patterns of nodal involvement for clinically N0 salivary gland carcinoma: refining the role of elective neck irradiation.

Head & Neck Pub Date : 2014-10-01 Epub Date: 2014-01-13 DOI:10.1002/hed.23467

Valerie H Lau, Rony Aouad, D Gregory Farwell, Paul J Donald, Allen M Chen

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引用次数: 68

Abstract

Background: The purpose of this study was to analyze the pattern of occult cervical lymph node metastasis among patients with clinically N0 salivary gland carcinoma.

Methods: One hundred nineteen patients underwent primary surgery and ipsilateral neck dissection for clinically N0 carcinomas of the major and minor salivary glands. Eighty patients (67%) had parotid tumors. Distribution of T classification was: T1 (18%), T2 (28%), T3 (23%), and T4 (32%).

Results: Twenty-five patients (21%) had pathological cervical disease. The incidence was highest among patients with adenocarcinoma (35%) and high-grade mucoepidermoid carcinoma (35%). The most common site of cervical lymph node metastasis was level II (71%), followed by level III (15%), and level IB (8%). On multivariate analysis, histological subtype was independently predictive of occult pathological lymph node metastasis (p < .001).

Conclusion: The likelihood of occult cervical lymph node metastasis for patients with salivary gland carcinoma is driven predominantly by histological subtype. Implications for elective neck irradiation are discussed.

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临床涎腺癌淋巴结受累模式:细化择期颈部照射的作用。

背景:本研究的目的是分析临床N0型唾液腺癌患者隐匿性颈淋巴转移的模式。方法:对119例大、小唾液腺癌患者行原发性手术及同侧颈部清扫术。80例(67%)患者有腮腺肿瘤。T分型分布为:T1(18%)、T2(28%)、T3(23%)、T4(32%)。结果:病理宫颈病变25例(21%)。腺癌(35%)和高级别粘液表皮样癌(35%)的发病率最高。最常见的颈部淋巴结转移部位是II级(71%)，其次是III级(15%)和IB级(8%)。在多变量分析中，组织学亚型是隐匿性病理性淋巴结转移的独立预测因子(p < 0.001)。结论:涎腺癌患者隐匿性颈淋巴转移的可能性主要由组织学亚型决定。讨论了择期颈部照射的意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Head & Neck

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