Chwee Ming Lim1, Mark R Gilbert, Jonas T Johnson, Seungwon Kim. 1. Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania; Department of Otolaryngology Head and Neck Surgery, National University Health System, Singapore.
Abstract
BACKGROUND: The clinical utility of intraparotid lymph node metastasis in primary parotid cancer is unknown, and this study was undertaken to address this gap in knowledge. METHODS: A medical chart review was performed on 86 patients who underwent parotidectomy with neck dissection (39 cN+ and 47 cN0). The disease-specific mortality and locoregional recurrence (LRR) were correlated with intraparotid lymph node metastasis status. RESULTS: Using intraparotid lymph node metastasis status to predict cervical nodal metastasis resulted in a sensitivity and specificity of 70% and 90.6%, respectively (positive predictive value [PPV] of 87.3%). Patients with positive intraparotid lymph node metastasis had a worse 3-year disease-specific mortality compared with patients with negative intraparotid lymph node metastasis (p = .0037). Patients with cN0 neck but positive intraparotid lymph node metastasis were more likely to develop locoregional recurrence than patients without intraparotid lymph node metastasis (p = .08). CONCLUSION: In patients with cN0 neck but positive intraparotid lymph node metastasis, intraparotid lymph node metastasis presence was strongly associated with a worse disease-specific survival and placed them at a higher risk of locoregional recurrence.
BACKGROUND: The clinical utility of intraparotid lymph node metastasis in primary parotid cancer is unknown, and this study was undertaken to address this gap in knowledge. METHODS: A medical chart review was performed on 86 patients who underwent parotidectomy with neck dissection (39 cN+ and 47 cN0). The disease-specific mortality and locoregional recurrence (LRR) were correlated with intraparotid lymph node metastasis status. RESULTS: Using intraparotid lymph node metastasis status to predict cervical nodal metastasis resulted in a sensitivity and specificity of 70% and 90.6%, respectively (positive predictive value [PPV] of 87.3%). Patients with positive intraparotid lymph node metastasis had a worse 3-year disease-specific mortality compared with patients with negative intraparotid lymph node metastasis (p = .0037). Patients with cN0 neck but positive intraparotid lymph node metastasis were more likely to develop locoregional recurrence than patients without intraparotid lymph node metastasis (p = .08). CONCLUSION: In patients with cN0 neck but positive intraparotid lymph node metastasis, intraparotid lymph node metastasis presence was strongly associated with a worse disease-specific survival and placed them at a higher risk of locoregional recurrence.
Authors: Reza Assadsangabi; Rosa Babaei; Catherine Songco; Vladimir Ivanovic; Matthew Bobinski; Yin J Chen; Seyed Ali Nabavizadeh Journal: Radiol Med Date: 2021-05-16 Impact factor: 3.469