Elective neck dissection versus observation in primary parotid carcinoma.

Abstract

OBJECTIVE:

To evaluate the efficacy of elective neck dissection in the clinically negative neck of patients with primary carcinoma of the parotid gland. Study design and setting A retrospective analysis was undertaken at a university Department of Otorhinolaryngology-Head and Neck Surgery on 83 previously untreated patients with primary carcinoma of the parotid gland and a clinically negative neck. The reliability of fine needle aspiration cytology, frozen section, and the clinico-pathologic findings of patients with occult neck metastases were analyzed. The regional recurrence rate and the outcome were compared among 2 groups; one with elective neck dissection (N = 41) and one without elective neck dissection (N = 42).

RESULTS:

The diagnosis of malignancy was known preoperatively in 59 (71%) cases, the exact histologic tumor type in 36 (43%) and the grade in 37 (44%) of 83 cases. Occult metastases were detected in 8 (20%) of 41 cNO patients, in 5 cases associated with a high-grade and in 3 cases with a low-grade carcinoma. Recurrence of disease developed in 5 (12%) patients in the elective neck dissection group and in 11 (26%) patients in the observation group. All of the 7 neck recurrences occurred in the observation group. The 5-year actuarial and disease-free survival rate was 80% and 86% for patients with elective neck dissection and 83% and 69% for patients without neck dissection. Conclusion and significance A routine elective neck dissection is suggested in all patients with primary carcinoma of the parotid gland. The efficacy of elective neck dissection, nevertheless, has never been evaluated prospectively.

• Authors: P Zbären, J Schüpbach, M Nuyens, E Stauffer
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 132 Issue 3 Pg. 387-91 (Mar 2005) ISSN: 0194-5998 [Print] England
• PMID: 15746848 (Publication Type: Comparative Study, Journal Article)

Topics

• Biopsy, Needle
• Carcinoma (pathology, surgery)
• Elective Surgical Procedures
• Frozen Sections
• Humans
• Middle Aged
• Neck Dissection
• Parotid Neoplasms (pathology, surgery)
• Reproducibility of Results
• Retrospective Studies