Elective neck dissection in salivary gland malignancies: Systematic review and meta-analysis

Head Neck. 2022 Feb;44(2):505-517. doi: 10.1002/hed.26923. Epub 2021 Dec 4.


We defined the occult nodal metastasis (ONM) rate of clinical node-negative salivary gland malignancies and examined the role of elective neck dissection (END). Meta-analysis querying four databases, from inception of databases to March 25th, 2020. Fifty-one studies with 11 698 patients were included. ONM rates were 64% for salivary ductal carcinoma (SDC), 51% for undifferentiated carcinoma, 34% for carcinoma ex-pleomorphic adenoma (CXPA), 32% for adenocarcinoma not otherwise specified (ANOS), 31% for lymphoepithelial carcinoma (LE), 20% for mucoepidermoid carcinoma, 17% for acinic cell carcinoma, and 17% for adenoid cystic carcinoma. T3/T4 tumors had a 2.3 times increased risk of ONM than T1/T2 tumors. High-grade tumors had a 3.8 times increased risk of ONM than low/intermediate-grade tumors. ONM rates were exceedingly high for T3/T4, high-grade, and undifferentiated, SDC, ANOS, CXPA, and LE tumors, indicating the potential role of END.

Keywords: elective neck dissection; occult nodal metastasis; parotid cancer; salivary gland cancer; salivary gland malignancy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Acinar Cell* / pathology
  • Carcinoma, Adenoid Cystic* / pathology
  • Carcinoma, Squamous Cell*
  • Humans
  • Neck Dissection
  • Salivary Gland Neoplasms* / pathology
  • Salivary Gland Neoplasms* / surgery