Original Report

Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma

Corresponding Author

Cilgia Dür MD

[email protected]

orcid.org/0000-0002-9754-7269

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

Send correspondence to Cilgia Dür, MD, Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. E-mail: [email protected]

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Cinzia Salmina MD,

Cinzia Salmina MD

Department of Otorhinolaryngology, Head and Neck Surgery; Hospitals FMI AG, Unterseen, Switzerland

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Urs Borner MD,

Urs Borner MD

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

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Roland Giger MD,

Roland Giger MD

orcid.org/0000-0002-5574-3210

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

These authors contributed equally to this work.

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Lluís Nisa,

Lluís Nisa

orcid.org/0000-0003-0632-1676

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

These authors contributed equally to this work.

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Cilgia Dür MD,

Corresponding Author

Cilgia Dür MD

[email protected]

orcid.org/0000-0002-9754-7269

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

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Cinzia Salmina MD,

Cinzia Salmina MD

Department of Otorhinolaryngology, Head and Neck Surgery; Hospitals FMI AG, Unterseen, Switzerland

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Urs Borner MD,

Urs Borner MD

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

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Roland Giger MD,

Roland Giger MD

orcid.org/0000-0002-5574-3210

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

These authors contributed equally to this work.

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Lluís Nisa,

Lluís Nisa

orcid.org/0000-0003-0632-1676

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

These authors contributed equally to this work.

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First published: 12 September 2020

https://doi.org/10.1002/lary.28985

Citations: 6

Editor's Note: This Manuscript was accepted for publication on July 13, 2020.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

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

Supporting Information

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Citing Literature

Volume131, Issue4

April 2021

Pages 788-793

Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma

Abstract

Objectives

Study Design

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Information

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Relevance of Intraparotid Metastases in Head and Neck Skin Squamous Cell Carcinoma

Abstract

Objectives

Study Design

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Related

Information