Intraparotid node metastases in adults with parotid mucoepidermoid cancer: an indicator of prognosis?

We have retrospectively analysed the predictive value of intraparotid nodal metastases in patients having neck dissection for parotid mucoepidermoid cancer. The main outcomes were intraparotid nodal metastases, a new system for staging metastatic parotid nodes, and recurrence-free survival. The overall rate of intraparotid metastasis was 30/122 (25%), and seven patients had deep parotid nodal metastases. This metastasis was significantly related to tumour stage, neck disease, perineural invasion, lymphovascular invasion, and pathological tumour grade. The sensitivity of intraparotid nodal metastases in predicting neck disease was 50%, and the specificity of them predicting neck disease was 89%. The stages of the intraparotid nodes were as follows: P0 (n=92 patients), P1 (n=10), P2 (n=16), and P3 (n=4). A Cox's model analysis confirmed that the stage of the intraparotid nodes was an independent prognostic factor for recurrence, so the presence of intraparotid nodal metastases is associated with a higher risk for recurrence of disease.