The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma.

Abstract

PURPOSE:

To evaluate whether elective neck dissection (END) was beneficial for cN0 patients with salivary gland carcinoma.

MATERIALS AND METHODS:

The rates of regional failure-free survival and disease-free survival were calculated using Kaplan-Meier methods and Cox models. The risk factors for occult lymph node metastasis (OLNM) in cN0 patients undergoing END was analyzed using logistic regression. A nomogram was formulated to calculate the estimated probability of OLNM.

RESULTS:

Neck dissection was performed in 84 patients (43.3%). OLNM was detected in eight of the patients who underwent END. During the follow-up period, regional recurrences involving cervical lymph nodes were found in 10 patients. Cox model analysis revealed that neck dissection was not related to regional failure-free survival and disease-free survival. Logistic regression analysis revealed that older age, neural symptoms, and positive adjacent lymph nodes were associated with OLNM. A nomogram comprising age, neural symptoms, and adjacent lymph nodes was developed to predict the risk of OLNM.

CONCLUSION:

The incidence of OLNM was low in cN0 patients after detailed preoperative evaluations. There was no strong evidence supporting END as a conventional therapy in cN0 patients with salivary cancers. Our nomogram is a simple and practical instrument for strengthening the prediction of OLNM.

• Authors: Kai Qian, Kai Guo, Xiaoke Zheng, Wenyu Sun, Tuanqi Sun, Lili Chen, Ding Ma, Yi Wu, Qinghai Ji, Zhuoying Wang
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 47 Issue 1 Pg. 47-52 (Jan 2019) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 30528947 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Elective Surgical Procedures (methods)
• Female
• Humans
• Logistic Models
• Lymph Nodes (surgery)
• Lymphatic Metastasis
• Male
• Middle Aged
• Neck Dissection (methods)
• Neoplasm Recurrence, Local (surgery, therapy)
• Nomograms
• Risk Factors
• Salivary Gland Neoplasms (surgery, therapy)
• Salivary Glands (surgery)
• Survival Rate
• Young Adult