Is level V neck dissection necessary in primary parotid cancer?

Abstract

OBJECTIVES/HYPOTHESIS:

This study aims to evaluate the pattern of nodal metastasis to level V in parotid cancer and to examine the clinical value of level V neck dissection (LVND).

STUDY DESIGN:

Retrospective cohort study.

METHODS:

Retrospective chart review of 86 patients (47 N0 nodal metastasis [N0] neck and 39 positive nodal metastasis [N(+) ] neck) who received parotidectomy and neck dissection was performed. The prevalence of pathological nodal metastasis in level V neck was evaluated and correlated with locoregional recurrence.

RESULTS:

LVND was performed in 10.6% and 28.2% of patients with clinical NO (cN0) and cN(+) neck disease, respectively. The prevalence of pathological positive nodal metastasis was 0% (cN0) and 81.8% (cN(+) ). In patients with cN0 neck, the rate of recurrence in level V was 6%.

CONCLUSION:

In our patient cohort with predominantly high-grade parotid cancer, LVND was necessary in patients with cN(+) neck because there was a high likelihood for pathologically positive nodal metastasis. In patients with cN0 neck, the rate of recurrence in level V was low enough not to warrant a routine inclusion of LVND.

• Authors: Chwee M Lim, Mark Gilbert, Jonas T Johnson, Seungwon Kim
• Journal: The Laryngoscope (Laryngoscope) Vol. 125 Issue 1 Pg. 118-21 (Jan 2015) ISSN: 1531-4995 [Electronic] United States
• PMID: 24965707 (Publication Type: Journal Article)
• Copyright: © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Topics

• Aged
• Cohort Studies
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Lymphatic Metastasis (pathology)
• Male
• Middle Aged
• Neck Dissection (methods)
• Neoplasm Recurrence, Local (mortality, pathology, prevention & control)
• Neoplasm Staging
• Parotid Gland (pathology, surgery)
• Parotid Neoplasms (mortality, pathology, surgery)
• Pennsylvania
• Registries
• Retrospective Studies