Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T13:44:51.819Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of neck dissection in metastatic squamous cell carcinoma to the parotid gland

Published online by Cambridge University Press:  04 August 2016

S W Park ,
T Eade ,
L Pang ,
A Wignall  and
D Veivers
S W Park
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney, Australia
T Eade
Affiliation:
Northern Clinical School, University of Sydney, Australia Department of Radiation Oncology, Northern Sydney Cancer Centre, Australia
L Pang
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney, Australia Northern Clinical School, University of Sydney, Australia
A Wignall
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney, Australia
D Veivers*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney, Australia Northern Clinical School, University of Sydney, Australia
*
Address for correspondence: Assoc Prof David P Veivers, Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, Sydney, Australia Fax: +61 2 9906 4355 E-mail: david.veivers@sydney.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate the rate of occult neck disease in patients with metastatic squamous cell carcinoma to the parotid gland following parotidectomy and neck dissection.

Methods:

A consecutive series of patients treated between 2000 and 2014 for metastatic squamous cell carcinoma to the parotid were analysed. Patients were included if they had no clinical or radiological evidence of neck disease. Pathology of parotidectomy and neck dissection specimens was reviewed. Other variables analysed included patient immune status, surgery type, complications, use of positron emission tomography scanning and treatment with radiotherapy.

Results:

Sixty-five patients had no clinical or radiological evidence of neck disease initially. Forty-six patients (70.8 per cent) underwent neck dissection. Occult neck disease was only found in 8 of the 46 patients (17.3 per cent). Occult neck disease was found more often in those with immunocompromise (5.7 vs 38.5 per cent, p = 0.003). Patients who were immunocompromised had a significantly worse disease-specific survival rate at five years (0 vs 92 per cent, p = 0.0001).

Conclusion:

Occult neck disease was seen in 17.3 per cent of patients and immunosuppression was a significant predictor for this.

Keywords

Squamous Cell CarcinomaParotid Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Supplement S4 , July 2016 , pp. S54 - S59
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 65th Annual Scientific Meeting of the Australian Society of Otolaryngology, Head and Neck Surgery, 7–9 March 2015, Sydney, Australia.

References

1 Goh, R, Bova, R, Fogarty, G. Cutaneous squamous cell carcinoma metastatic to parotid – analysis of prognostic factors and treatment outcome. World J Surg Oncol 2012;10:117 Google Scholar
2 Buettnner, PG, Raasch, BA. Incidence rates of skin cancer in Townsville, Australia. Int J Cancer 1998;78:587–93Google Scholar
3 Veness, M, Porceddu, S, Palme, C, Morgan, G. Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes. Head Neck 2007;29:621–31CrossRefGoogle ScholarPubMed
4 Bova, R, Saylor, A, Coman, W. Parotidectomy: review of treatment and outcomes. ANZ J Surg 2004;74:563–8CrossRefGoogle ScholarPubMed
5 Corlette, T, Cole, I, Albsoul, N, Ayyash, M. Neck dissection of level IIb: is it really necessary? Laryngoscope 2005;115:1624–6CrossRefGoogle ScholarPubMed
6 O'Brien, CJ, McNeil, EB, McMahon, JD, Pathak, I, Lauer, CS, Jackson, MA. Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland. Head Neck 2002;24:417–22Google Scholar
7 Audet, N, Palme, C, Gullane, P, Gilbert, RW, Brown, DH, Irish, J et al. Cutaneous metastatic squamous cell carcinoma to the parotid gland: analysis and outcome. Head Neck 2004;26:727–32CrossRefGoogle Scholar
8 Kirke, D, Porceddu, S, Wallwork, B, Panizza, B, Coman, W. Pathologic occult neck disease in patients with metastatic cutaneous squamous cell carcinoma to the parotid. Otolaryngol Head Neck Surg 2011;144:549–51CrossRefGoogle ScholarPubMed
9 Ying, Y, Johnson, J, Myers, E. Squamous cell carcinoma of the parotid gland. Head Neck 2006;28:626–32Google Scholar
10 O'Brien, CJ, McNeil, EB, McMahon, JD, Pathak, I, Lauer, CS. Incidence of cervical node involvement in metastatic cutaneous malignancy involving the parotid gland. Head Neck 2001;23:744–8Google Scholar
11 Dona, E, Veness, MJ, Cakir, B, Morgan, GJ. Metastatic cutaneous squamous cell carcinoma to the parotid: the role of surgery and adjuvant radiotherapy to achieve best outcome. ANZ J Surg 2003;73:692–6CrossRefGoogle Scholar
12 Moore, BA, Weber, RS, Prieto, V, El-Naggar, A, Holsinger, FC, Zhou, X et al. Lymph node metastases from cutaneous squamous cell carcinoma of the head and neck. Laryngoscope 2005;115:1561–7Google Scholar
13 Nuyens, M, Schupbach, J, Stauffer, E, Zbaren, P. Metastatic disease to the parotid gland. Otolaryngol Head Neck Surg 2006;135:844–8Google Scholar
14 Sweeny, L, Zimmerman, T, Carroll, WR, Schmalbach, CE, Day, KE, Rosenthal, EL. Head and neck cutaneous squamous cell carcinoma requiring parotidectomy: prognostic indicators and treatment selection. Otolaryngol Head Neck Surg 2014;150:610–17Google Scholar
15 D'Souza, J, Clark, J. Management of the neck in metastatic cutaneous squamous cell carcinoma of the head and neck. Curr Opin Otolaryngol Head Neck Surg 2011;19:99–105 Google Scholar
16 Shao, A, Wong, DK, McIvor, NP, Mylnarek, AM, Chaplin, JM, Izzard, ME et al. Parotid metastatic disease from cutaneous squamous cell carcinoma: prognostic role of facial nerve sacrifice, lateral temporal bone resection, immune status and P-stage. Head Neck 2014;36:545–50CrossRefGoogle ScholarPubMed
17 Gordin, A, Golz, A, Keidar, Z, Daitzchmann, M, Bar-Shalom, R, Israel, O. The role of FDG-PET/CT imaging in head and neck malignant conditions: impact on diagnostic accuracy and patient care. Otolaryngol Head Neck Surg 2007;137:130–7CrossRefGoogle ScholarPubMed
18 Yamazaki, Y, Saitoh, M, Notani, K, Tei, K, Totsuka, Y, Takinami, S et al. Assessment of cervical lymph node metastases using FDG-PET in patients with head and neck cancer. Ann Nucl Med 2007;22:177–84Google Scholar
19 Jeong, HS, Baek, CH, Son, YI, Ki Chung, M, Kyung Lee, D, Young Choi, J et al. Use of integrated 18F-FDG PET/CT to improve the accuracy of initial cervical nodal evaluation in patients with head and neck squamous cell carcinoma. Head Neck 2007;29:203–10Google Scholar