Elective neck management for high-grade salivary gland carcinoma.

Abstract

PURPOSE:

To determine whether patients with clinically node negative (cNo) high grade salivary gland carcinomas benefit from an elective neck dissection prior to postoperative radiotherapy (RT).

MATERIAL/METHODS:

Between October 1964 and October 2009, 59 previously untreated patients with cNo high-grade salivary gland carcinomas (squamous cell carcinomas were excluded) were treated with curative intent using elective neck dissection (END; n=41), or elective neck irradiation (ENI; n=18) at the University of Florida College of Medicine (Gainesville, FL). All patients underwent resection of the primary cancer followed by postoperative RT. The median follow-up period was 5.2years (range, 0.3-34years).

RESULTS:

Occult metastases were found in 18 (44%) of the 41 patients in the END group. There were 4 recurrences (10%) in the END group and 0 recurrence in the ENI group. Neck control rates at 5years were: END, 90%; ENI, 100%; and overall, 93% (p=0.1879). Cause-specific survival was 94% in the ENI group, 84% in the END group, and 86% for all patients (p=0.6998). There were 3 reported grade 3 or 4 toxicities. Two patients had a postoperative fistula and one patient had a grade 4 osteoradionecrosis that required a partial mandibulectomy.

CONCLUSIONS:

Patients with cNo high grade salivary gland carcinomas who are planned to undergo surgery and postoperative RT likely do not benefit from a planned neck dissection.

• Authors: Michael P Herman, John W Werning, Christopher G Morris, Jessica M Kirwan, Robert J Amdur, William M Mendenhall
• Journal: American journal of otolaryngology (Am J Otolaryngol) 2013 May-Jun Vol. 34 Issue 3 Pg. 205-8 ISSN: 1532-818X [Electronic] United States
• PMID: 23332405 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Adenocarcinoma (radiotherapy, surgery)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Adenoid Cystic (radiotherapy, surgery)
• Carcinoma, Mucoepidermoid (radiotherapy, surgery)
• Elective Surgical Procedures
• Female
• Humans
• Lymph Node Excision
• Male
• Middle Aged
• Neoplasm Recurrence, Local (surgery)
• Radiotherapy, Adjuvant
• Retrospective Studies
• Salivary Gland Neoplasms (radiotherapy, surgery)
• Young Adult