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.


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