Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review

Orlando Guntinas-Lichius; Jovanna Thielker; K Thomas Robbins; Kerry D Olsen; Ashok R Shaha; Antti A Mäkitie; Remco de Bree; Vincent Vander Poorten; Miquel Quer; Alessandra Rinaldo; Luiz Paulo Kowalski; Juan Pablo Rodrigo; Marc Hamoir; Alfio Ferlito

doi:10.1002/hed.26541

Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review

Head Neck. 2021 Mar;43(3):997-1008. doi: 10.1002/hed.26541. Epub 2020 Nov 9.

Authors

Orlando Guntinas-Lichius^{1

2

3}, Jovanna Thielker^{1

2}, K Thomas Robbins⁴, Kerry D Olsen⁵, Ashok R Shaha⁶, Antti A Mäkitie^{7

8

9}, Remco de Bree¹⁰, Vincent Vander Poorten^{3

11}, Miquel Quer^{3

12}, Alessandra Rinaldo¹³, Luiz Paulo Kowalski¹⁴, Juan Pablo Rodrigo¹⁵, Marc Hamoir¹⁶, Alfio Ferlito¹⁷

Affiliations

¹ Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
² Facial Nerve Center, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
³ Multidisciplinary Salivary Gland Society, Geneva, Switzerland.
⁴ Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University, Springfield, Illinois, USA.
⁵ Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA.
⁶ Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
⁷ Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁸ Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
⁹ Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden.
¹⁰ Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
¹¹ Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven and Department of Oncology, Section Head and Neck Oncology, Leuven, Belgium.
¹² Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
¹³ University of Udine School of Medicine, Udine, Italy.
¹⁴ Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, and Division of Head and Neck Surgery, Sao Paulo State University Medical School, São Paulo, Brazil.
¹⁵ Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain.
¹⁶ Department of Head & Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
¹⁷ Coordinator of the International Head and Neck Scientific Group, Padua, Italy.

PMID: 33169420
DOI: 10.1002/hed.26541

Abstract

Background: The prognostic importance of intraparotid lymph node metastasis (P+) in patients with primary parotid gland carcinoma is unclear.

Methods: Nineteen retrospective and noncomparative cohort studies, published between 1992 and 2020, met the inclusion criteria and included 2202 patients for this systematic review.

Results: The pooled prevalence of the P in adult patients in the unselected studies was 24.10% (95% confidence interval = 17.95-30.25). The number of P+ lymph nodes per patient was counted in only three studies and ranged from 1 to 11. The 5-year recurrence-free survival rate based on Kaplan-Meier analysis varied from 83% to 88% in P- patients compared to 36% to 54% in P+ patients. The average hazard ratio for tumor recurrence in patients with P+ compared to P- was 2.67 ± 0.58.

Conclusions: P+ is an independent negative prognostic factor in primary parotid gland cancer and should be included into the treatment planning.

Keywords: clinical significance; intraparotid lymph node metastasis; nodal metastasis; prevalence; primary parotid cancer; survival.

Publication types

Review
Systematic Review

MeSH terms

Adult
Humans
Lymph Nodes / pathology
Lymphatic Metastasis
Neoplasm Recurrence, Local / pathology
Neoplasm Staging
Parotid Neoplasms* / pathology
Prognosis
Retrospective Studies