Premium
Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma
Author(s) -
Dür Cilgia,
Salmina Cinzia,
Borner Urs,
Giger Roland,
Nisa Lluís
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28985
Subject(s) - medicine , occult , neck dissection , univariate analysis , lymph node , concomitant , parotidectomy , radiology , head and neck cancer , retrospective cohort study , head and neck squamous cell carcinoma , lymph , carcinoma , cancer , oncology , parotid gland , pathology , multivariate analysis , alternative medicine
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 , 131:788–793, 2021