Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma.

Dür, Cilgia; Salmina, Cinzia; Borner, Urs; Giger, Roland; Nisa, Lluís (2021). Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma. The Laryngoscope, 131(4), pp. 788-793. Wiley 10.1002/lary.28985

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OBJECTIVES

Parotid lymph node metastases are common in head and neck cutaneous squamous cell carcinoma (cSCCHN). Here we evaluate the diagnostic, prognostic, and therapeutic implications of intraglandular lymph node (IGLN) metastases in cSCCHN.

STUDY DESIGN

Retrospective study in a tertiary referral university cancer institute.

METHODS

We included patients with cSCCHN who underwent parotidectomy and neck dissection (ND), with or without synchronous resection of the skin primary, between January 1999 and January 2018. The characteristics of cSCCHN with or without IGLN involvement were compared.

RESULTS

Altogether, 68 patients were included. Of the 29 (42.6%) patients classified as cN0, eight were upstaged pN+ and had concomitant IGLN involvement. Of 21 patients with pN0 disease, IGLN metastases were absent in only three cases, resulting in a specificity and sensitivity of parotid metastases to diagnose occult nodal neck metastases of 14.29% and 100%, respectively. The positive and negative predictive values were 14.29% and 100%, respectively. Univariate analyses only displayed a significantly higher rate of moderately and poorly differentiated primaries in patients with IGLN metastases (P = .015). Only advanced T-stages were significantly associated with neck recurrences.

CONCLUSION

IGLN status in advanced cSCCHN is potentially predictive for occul nodal neck metastases. Our results suggest that ND in patients with histopathologically negative IGLNs and clinically negative neck lymph nodes may not be necessary given the high negative predictive value of IGLN status in this group of patients. Therefore, accurate diagnostic evaluation of IGLN involvement is mandatory.

LEVEL OF EVIDENCE

4 Laryngoscope, 2020.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Dür, Cilgia, Borner, Urs, Giger, Roland, Nisa Hernandez, Lluis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1531-4995

Publisher:

Wiley

Language:

English

Submitter:

Stefan Weder

Date Deposited:

18 Jan 2021 16:30

Last Modified:

02 Mar 2023 23:34

Publisher DOI:

10.1002/lary.28985

PubMed ID:

32918494

Uncontrolled Keywords:

Cutaneous squamous cell carcinoma head and neck neck dissection neck metastasis parotid metastasis parotidectomy

BORIS DOI:

10.48350/150351

URI:

https://boris.unibe.ch/id/eprint/150351

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