The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Qian, Kai; Guo, Kai; Zheng, Xiaoke; Sun, Wenyu; Sun, Tuanqi; Chen, Lili; Ma, Ding; Wu, Yi; Ji, Qinghai; Wang, Zhuoying
• Is Part Of: Journal of cranio-maxillofacial surgery. Volume 47:Issue 1(2019)
• Page Start: 47
• Page End: 52
• Publication Date: 2019-01
• Subjects: Salivary gland carcinoma -- Elective neck dissection -- Lymph node metastasis -- Nomogram; Skull -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; Maxilla -- surgery -- Periodicals; Face -- surgery -- Periodicals; Skull -- surgery -- Periodicals; Oral Surgical Procedures -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Periodicals; Surgery, Oral -- Periodicals; Electronic journals; 617.514
• DOI: 10.1016/j.jcms.2018.09.036
• Languages: English
• ISSNs: 1010-5182

Abstract

Abstract: Purpose: To evaluate whether elective neck dissection (END) was beneficial for cN0 patients with salivary gland carcinoma. Materials and methods: The rates of regional failure-free survival and disease-free survival were calculated using Kaplan–Meier methods and Cox models. The risk factors for occult lymph node metastasis (OLNM) in cN0 patients undergoing END was analyzed using logistic regression. A nomogram was formulated to calculate the estimated probability of OLNM. Results: Neck dissection was performed in 84 patients (43.3%). OLNM was detected in eight of the patients who underwent END. During the follow-up period, regional recurrences involving cervical lymph nodes were found in 10 patients. Cox model analysis revealed that neck dissection was not related to regional failure-free survival and disease-free survival. Logistic regression analysis revealed that older age, neural symptoms, and positive adjacent lymph nodes were associated with OLNM. A nomogram comprising age, neural symptoms, and adjacent lymph nodes was developed to predict the risk of OLNM. Conclusion: The incidence of OLNM was low in cN0 patients after detailed preoperative evaluations. There was no strong evidence supporting END as a conventional therapy in cN0 patients with salivary cancers. Our nomogram is a simple and practical instrument for strengthening the prediction of OLNM.