Indications of elective neck dissection and postoperative radiotherapy for parotid cancers

• Shibata Tomohisa

  Kobe University Hospital, Department of Otolaryngology-Head and neck surgery

• Yonezawa Kouichiro

  Kobe University Hospital, Department of Otolaryngology-Head and neck surgery

• Morimoto Koichi

  Kobe University Hospital, Department of Otolaryngology-Head and neck surgery

• Yamashita Daisuke

  Kobe University Hospital, Department of Otolaryngology-Head and neck surgery

• Otsuki Naoki

  Kobe University Hospital, Department of Otolaryngology-Head and neck surgery

• Nishimura Hideki

  Kobe University Hospital, Department of Radio-Oncology

• Sasaki Ryohei

  Kobe University Hospital, Department of Radio-Oncology

• Nibu Ken-ichi

  Kobe University Hospital, Department of Otolaryngology-Head and neck surgery

Bibliographic Information

Other Title

• 耳下腺癌における予防的頸部郭清と術後放射線治療について

Abstract

INTRODUCTION: Regional lymph node metastases significantly influence the prognosis of patients with parotid cancer. To assess our indications of elective neck dissection and postoperative radiotherapy for parotid cancer, a retrospective chart review was performed.<br>MATERIALS AND METHODS: Between 2001 and 2009, 35 patients with parotid cancer were initially treated at our department. The median follow-up was 30 months (range, 10-90 months).<br>RESULTS: Out of all patients, 31 (89%) patients were preoperatively diagnosed as malignant, while 4 (11%) patients were initially diagnosed as benign. Mucoepidermoid carcinoma was the most common histological type (10 patients). Twenty-two tumors (63%) were pathologically diagnosed as high-grade. The numbers of patients with Stages I, II, III, and IVA were 3, 10, 7, and 15, respectively. Ipsilateral neck dissection (Level II-V) was performed in seven patients with clinically positive neck metastasis (cN+), and in ten patients without lymph node metastasis who had T4 disease, high-grade malignancy, or positive neck (Level II) metastasis during intraoperative evaluation. Postoperative radiotherapy was performed in 24 patients with pathological T4, high-grade malignancy, positive surgical margin, multiple neck metastasis and/or extranodal extension (ENI). Seven of 28 (25%) patients with clinically N0 had pathologically positive neck metastasis (pN+). Regional recurrence developed in one patient with high-grade malignancy and ENI (T4N2b). Disease-specific survival rates for Stages I, II, III, and IVA at 3 years were 100%, 73%, 100%, and 37%, respectively. Loco-regional control rates for pN0 (21 patients) and pN+ (14 patients) at 3 years were 90% and 95%, respectively.<br>CONCLUSION: Our present favorable loco-regional control supported our current indications of elective neck dissection and postoperative radiotherapy. We also recommend intraoperative biopsy of level IIB nodes to study the need for elective neck dissection.

Journal

• Toukeibu Gan

  Toukeibu Gan 37 (1), 78-82, 2011

  Japan Society for Head and Neck Cancer

Keywords

• Parotid cancer
• Elective neck dissection
• Postoperative radiotherapy

Details

• CRID: 1390001205221263744
• NII Article ID: 10030814927
• NII Book ID: AA11985555
• DOI: 10.5981/jjhnc.37.78
• ISSN: 18818382
• ISSN: 13495747
• Web Site: https://search.jamas.or.jp/link/ui/2011212850
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed