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Song Y, He Y, Li H, Zhao L, Liu Y, Liu S. Intraparotid node metastasis affects the long-term survival of patients with resectable recurrent parotid gland carcinoma. Eur Arch Otorhinolaryngol 2023; 280:5547-5555. [PMID: 37493846 DOI: 10.1007/s00405-023-08142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE The recurrence rate of parotid gland cancer is high, but research on the prognosis of recurrent parotid gland cancer (RPC) is relatively limited. We aim to determine the potential prognosis factors of RPC. STUDY DESIGN Retrospective cohort analysis. SETTING Tertiary cancer center. METHODS We conducted a retrospective review from 2012 to 2021 on RPC patients treated at the China National Cancer Center (CNCC). To analyze the impact of various variables on overall survival (OS) after recurrence, a univariate and multivariate Cox proportional hazard model was employed. RESULTS A total of 50/218 (23.0%) patients diagnosed with RPC and underwent surgery. The 5-year OS of all RPC patients in this cohort was 61.9%. 5 of 50 patients (10%) exhibited intraparotid node (IPN) metastasis. By univariate and multivariate analyses, we found that IPN metastasis was one of the prognostic factors of OS (p = 0.039) in RPC patients. The presence of IPN metastasis was also related to poor survival in individuals with negative cervical lymph nodes (CN0) (p = 0.011). In terms of the influence of surgical margins on prognosis, our findings revealed that RPC patients with negative margins exhibited a higher survival result than those with positive margins (p = 0.002). CONCLUSION According to this study, IPN metastasis indicate a high incidence of mortality in recurrent parotid cancer patients. Particularly, in CN0 patients, the presence of IPN metastasis was associated with poor survival in CN0 patients.
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Affiliation(s)
- Yixuan Song
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yuqin He
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Han Li
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Li Zhao
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yang Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shaoyan Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
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2
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Current Issues in Treatment of Parotid Gland Cancer and Advanced Surgical Technique of Robotic Parotidectomy. Curr Oncol Rep 2022; 24:203-208. [DOI: 10.1007/s11912-021-01167-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/03/2022]
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3
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Bradley PJ. Parotid lymph nodes in primary malignant salivary neoplasms. Curr Opin Otolaryngol Head Neck Surg 2021; 30:99-106. [DOI: 10.1097/moo.0000000000000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Guntinas-Lichius O, Thielker J, Robbins KT, Olsen KD, Shaha AR, Mäkitie AA, de Bree R, Vander Poorten V, Quer M, Rinaldo A, Kowalski LP, Rodrigo JP, Hamoir M, Ferlito A. Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review. Head Neck 2020; 43:997-1008. [PMID: 33169420 DOI: 10.1002/hed.26541] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/30/2020] [Accepted: 10/30/2020] [Indexed: 12/14/2022] Open
Abstract
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.
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Affiliation(s)
- Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Facial Nerve Center, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Multidisciplinary Salivary Gland Society, Geneva, Switzerland
| | - Jovanna Thielker
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Facial Nerve Center, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - K Thomas Robbins
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University, Springfield, Illinois, USA
| | - Kerry D Olsen
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vincent Vander Poorten
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven and Department of Oncology, Section Head and Neck Oncology, Leuven, Belgium
| | - Miquel Quer
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, and Division of Head and Neck Surgery, Sao Paulo State University Medical School, São Paulo, Brazil
| | - Juan Pablo Rodrigo
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Marc Hamoir
- Department of Head & Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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5
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Abou-Foul AK. Surgical anatomy of the lymphatic drainage of the salivary glands: a systematic review. J Laryngol Otol 2020; 134:1-7. [PMID: 33023690 DOI: 10.1017/s0022215120002054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Nodal metastasis in salivary gland malignancies has important clinical implications; a good understanding of their complex anatomy is paramount to the head and neck surgeon. METHODS A contemporary and comprehensive literature review was conducted of the lymphatic drainage of the salivary glands, with special emphasis on its surgical applications. RESULTS The parotid gland has extraglandular and intraglandular nodes acting as a single functional drainage unit. Intraglandular parotid notes are unique to the parotid gland, and consist of a larger superficial group and a smaller deep group. The presence of intraglandular submandibular nodes, as described by early anatomists, is much debated nowadays. The sublingual glands drain to the lingual lymph nodes, which are divided into median, intermediate and lateral groups. CONCLUSION This review highlights the complex arrangements of lymph nodes draining the salivary glands. It may provide a valid anatomical explanation for the nodal metastasis patterns commonly seen in salivary gland malignancy.
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Affiliation(s)
- A K Abou-Foul
- Department of Otolaryngology, Head and Neck Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
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6
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Sönmez S, Orhan KS, Kara E, Büyük M, Aydemir L, Asliyüksek H. Determining the number and distribution of intraparotid lymph nodes according to parotidectomy classification of European Salivary Gland Society: Cadaveric study. Head Neck 2020; 42:3685-3692. [PMID: 32840937 DOI: 10.1002/hed.26434] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/22/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate the distribution of the parotid gland's intraglandular lymph nodes using the parotidectomy zones determined by the parotidectomy classification of the European Salivary Gland Society (ESGS). MATERIALS AND METHODS A total of 128 parotid glands were dissected from 64 fresh cadavers, by bilateral parotidectomy without additional incision within the standard autopsy procedure, and categorized. RESULTS Eighty-six percent of the IGLNs were located in the superficial lobe and 14% in the deep lobe. An average of 7.09 ± 3.55 IGLNs were found for each of the gland; there were 6.11 ± 3.28 in the superficial lobe and 0.98 ± 1.46 in the deep lobe. While the most common lymph nodes were found in level 2 with 47.7%, only 5% of IGLNs were at level 4. According to the proposed modification, the most common lymph nodes (35.24%) were located at level 2B. CONCLUSION Level 2B was found to contain significantly more lymph nodes than other levels, which has not been evaluated before in literature.
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Affiliation(s)
- Said Sönmez
- Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Kadir Serkan Orhan
- Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Erdoğan Kara
- Ministry of Justice Council of Forensic Medicine, Istanbul, Turkey
| | - Melek Büyük
- Department of Pathology, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Levent Aydemir
- Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Hızır Asliyüksek
- Ministry of Justice Council of Forensic Medicine, Istanbul, Turkey
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7
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Abstract
(1) Background: Lateral or total parotidectomy are the standard surgical treatments for malignant parotid tumors. However, some authors have proposed a more limited procedure. (2) Methods: We performed a review of the literature on this topic. Studies were included that met the following criteria: malignant parotid tumors, information about the extent of surgical resection, treated with less than a complete lateral lobectomy, and information on local control and/or survival. Nine articles fulfilled the inclusion criteria. (3) Results: Eight of the nine series reported favorable results for the more limited approaches. Most used them for small, mobile, low-grade cancers in the lateral parotid lobe. Most authors have used a limited partial lateral lobectomy for a presumed benign lesion. The remaining study analyzed pediatric patients treated with enucleation with poor local control. (4) Conclusions: There is weak evidence for recommending less extensive procedures than a lateral parotid lobectomy. In the unique case of a partial lateral parotidectomy performed for a tumor initially thought to be benign but pathologically proved to be malignant, close follow-up can be recommended for low grade T1 that has been excised with free margins and does not have adverse prognostic factors.
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8
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Wu J, Fang Q, Liu F, Zhang X. Intraparotid node metastases in adults with parotid mucoepidermoid cancer: an indicator of prognosis? Br J Oral Maxillofac Surg 2020; 58:525-529. [DOI: 10.1016/j.bjoms.2019.10.323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/26/2019] [Indexed: 02/07/2023]
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9
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Israel Y, Rachmiel A, Gourevich K, Nagler R. Mortality rates and prognostic factors in patients with malignant salivary tumors. Med Oncol 2019; 36:65. [PMID: 31165942 DOI: 10.1007/s12032-019-1284-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/18/2019] [Indexed: 11/26/2022]
Abstract
Malignancies of the salivary glands represent a multifarious disease. Evaluating the prognostic factors of these malignancies may help predict patient outcome and aid decision-making in choosing the most suitable therapy. We examined the role of various salivary tumorigenic, clinical and therapeutic features in a cohort of 101 patients diagnosed and treated for primary malignant salivary tumors. These include histo-pathological diagnosis, stage, grade and T, N, M values as well as the existence of perineural invasion and extra-parenchymal spread. We also identified the salivary gland involved, the sub-compartment specific location of the tumor and the therapy administered. All these were related to mortality. Of the 101 patients examined, 79 survived and 22 died due to the disease. Tumor staging, distant metastasis and perineural invasion were highly significant predictors of increased lethality. Histo-pathological grading was also a predictor but to a lesser degree. Neither neck metastasis nor tumor size or type had a significant impact on lethality. Performing neck dissections did not decrease lethality rate. Location of the tumor in the parotid gland and more so in its deep lobe adversely affected lethality; extra-parenchymal spread also had an adverse effect. Our results seem to indicate hematogenous rather than lymphogenous spread of metastasis from malignant salivary tumors. The highest therapeutic priority should be achieving full local control of the disease by safe removal of the primary salivary tumor, accompanied by regional control of perineural invasion and extra-parenchymal spread and appropriate systemic treatment aimed at eradicating distant metastasis.
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Affiliation(s)
- Yair Israel
- Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Technion - Israel Institute of Technology, 31096, Haifa, Israel
| | - Adi Rachmiel
- Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Technion - Israel Institute of Technology, 31096, Haifa, Israel
| | - Konstantin Gourevich
- Department of Nuclear Medicine, Rambam Medical Center, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Technion - Israel Institute of Technology, 31096, Haifa, Israel
| | - Rafael Nagler
- Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Technion - Israel Institute of Technology, 31096, Haifa, Israel.
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10
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Niu X, Fang Q, Liu F. Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland. BMC Cancer 2019; 19:417. [PMID: 31053107 PMCID: PMC6500062 DOI: 10.1186/s12885-019-5637-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 04/24/2019] [Indexed: 02/06/2023] Open
Abstract
Background Prognostic factors for parotid mucoepidermoid carcinoma (MEC) usually include disease grade, tumor stage, node stage, perineural invasion, and lymphovascular invasion. But the role of intraparotid nodes (IPNs) remains unclear, therefore, the study aimed to analyze the significance of IPNs in predicting recurrence in parotid MEC. Methods One hundred and ninety patients were included for analysis finally. Data regarding demography, pathological characteristics, IPN metastasis, TNM stage, follow up was collected and evaluated. The recurrence-free survival (RFS) was the main study endpoint. Results A total of 47 (24.7%) patients had IPN metastasis, and the IPN metastasis was significantly related to tumor stage, pathologic N stage, lymph-vascular invasion, perineural invasion, and disease grade. Recurrence occurred in 34 (17.9%) patients. For patients without IPN metastasis, the 10-year RFS rate was 88%, for patients with IPN metastasis, the 10-year RFS rate was 54%, the difference was significant (p < 0.001). Further Cox model analysis confirmed the independence of IPN metastasis in predicting the prognosis. Conclusion The IPN metastasis is relatively common in parotid MEC, it is significantly related to tumor stage and disease grade, IPN metastasis means worse recurrence-free survival.
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Affiliation(s)
- Xingyu Niu
- Department of Oral Medicine, The First Affiliated hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
| | - Qigen Fang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Fei Liu
- Department of Oral Medicine, The First Affiliated hospital of Zhengzhou University, Zhengzhou, People's Republic of China
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11
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Vitagliano G, Santoro G, Landolfi L, Cozzolino I, Peluso AL, Ieni A, Selleri C, Zeppa P. Fine‐needle cytology of intraglandular parotid lymph node: A useful procedure in the management of salivary gland nodules. Diagn Cytopathol 2019; 47:695-700. [DOI: 10.1002/dc.24177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/16/2019] [Accepted: 03/07/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Giulio Vitagliano
- Dipartimento di Sanità PubblicaUniversity of Naples “Federico II” Naples Italy
| | - Giuseppe Santoro
- Medicine and SurgeryAzienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
| | - Luigi Landolfi
- Medicine and SurgeryAzienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
| | - Immacolata Cozzolino
- Dipartimento di Salute Mentale e Fisica e MedicinaUniversità degli studi della Campania Luigi Vanvitelli Naples Italy
| | - Anna L. Peluso
- Dipartimento di Medicina e ChirurgiaUniversità di Salerno Salerno Italy
| | - Antonio Ieni
- Department of Human PathologyUniversity of Messina Messina Italy
| | - Carmine Selleri
- Dipartimento di Medicina e ChirurgiaUniversità di Salerno Salerno Italy
| | - Pio Zeppa
- Dipartimento di Medicina e ChirurgiaUniversità di Salerno Salerno Italy
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12
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Feng Y, Liu F, Cheng G, Fang Q, Niu X, He W. Significance of intraparotid node metastasis in predicting local control in primary parotid cancer. Laryngoscope 2018; 129:2309-2312. [PMID: 30549298 DOI: 10.1002/lary.27701] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Yanping Feng
- Department of Oral Medicinethe First Affiliated Hospital of Zhengzhou University Zhengzhou People's Republic of China
| | - Fei Liu
- Department of Oral Medicinethe First Affiliated Hospital of Zhengzhou University Zhengzhou People's Republic of China
| | - Guangyan Cheng
- Department of Oral Medicinethe First Affiliated Hospital of Zhengzhou University Zhengzhou People's Republic of China
| | - Qigen Fang
- Department of Head and NeckAffiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital Zhengzhou People's Republic of China
| | - Xinyu Niu
- Department of Oral Medicinethe First Affiliated Hospital of Zhengzhou University Zhengzhou People's Republic of China
| | - Wei He
- Department of Oral Medicinethe First Affiliated Hospital of Zhengzhou University Zhengzhou People's Republic of China
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13
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Hameed S, Chen H, Irfan M, Bajwa SZ, Khan WS, Baig SM, Dai Z. Fluorescence Guided Sentinel Lymph Node Mapping: From Current Molecular Probes to Future Multimodal Nanoprobes. Bioconjug Chem 2018; 30:13-28. [DOI: 10.1021/acs.bioconjchem.8b00812] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Sadaf Hameed
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Hong Chen
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Muhammad Irfan
- Department of Medicines, Gujranwala Medical College, Gujranwala 52250, Pakistan
| | - Sadia Zafar Bajwa
- National Institute of Biotechnology and Genetic Engineering, Faisalabad 38000, Pakistan
| | - Waheed S Khan
- National Institute of Biotechnology and Genetic Engineering, Faisalabad 38000, Pakistan
| | - Shahid Mahmood Baig
- National Institute of Biotechnology and Genetic Engineering, Faisalabad 38000, Pakistan
| | - Zhifei Dai
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
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14
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Olsen KD, Quer M, de Bree R, Vander Poorten V, Rinaldo A, Ferlito A. Deep lobe parotidectomy—why, when, and how? Eur Arch Otorhinolaryngol 2017; 274:4073-4078. [DOI: 10.1007/s00405-017-4767-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/04/2017] [Indexed: 11/29/2022]
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15
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Wertz AP, Durham AB, Malloy KM, Johnson TM, Bradford CR, McLean SA. Total versus superficial parotidectomy for stage III melanoma. Head Neck 2017; 39:1665-1670. [DOI: 10.1002/hed.24810] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Aileen P. Wertz
- Department of Otolaryngology - Head and Neck Surgery; University of Michigan Health System; Ann Arbor Michigan
| | - Alison B. Durham
- Department of Dermatology; University of Michigan Health System; Ann Arbor Michigan
| | - Kelly M. Malloy
- Department of Otolaryngology - Head and Neck Surgery; University of Michigan Health System; Ann Arbor Michigan
| | - Timothy M. Johnson
- Department of Dermatology; University of Michigan Health System; Ann Arbor Michigan
| | - Carol R. Bradford
- Department of Otolaryngology - Head and Neck Surgery; University of Michigan Health System; Ann Arbor Michigan
| | - Scott A. McLean
- Department of Otolaryngology - Head and Neck Surgery; University of Michigan Health System; Ann Arbor Michigan
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16
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Lombardi D, McGurk M, Vander Poorten V, Guzzo M, Accorona R, Rampinelli V, Nicolai P. Surgical treatment of salivary malignant tumors. Oral Oncol 2016; 65:102-113. [PMID: 28017651 DOI: 10.1016/j.oraloncology.2016.12.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/16/2016] [Accepted: 12/09/2016] [Indexed: 12/14/2022]
Abstract
Salivary gland malignant tumors (SGMT) are of key interest for head and neck surgeons since surgery with adjuvant radiotherapy is considered the treatment of choice in most of the cases. Some factors, namely rarity, high histologic heterogeneity, and possible occurrence in all the head and neck subsites, contribute to make this topic very controversial; some unclear aspects pertain surgical treatment. When dealing with major salivary gland malignant tumors (MaSGMT), the most debated issues remain the extent of surgery and management of facial nerve. In minor salivary gland malignant tumors (MiSGMT), conversely, surgical planning is influenced by the specific pattern of growth of the different neoplasms as well as the site of origin of the lesion. Finally, two additional issues, the treatment of the neck (therapeutic or elective) and reconstructive strategy after ablative surgery, are of pivotal importance in management of both MaSGMT and MiSGMT. In this review, we discuss the most relevant and controversial issues concerning surgery of SGMT.
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Affiliation(s)
- Davide Lombardi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy.
| | - Marc McGurk
- Guys and St. Thomas NHS Trust, London, United Kingdom
| | - Vincent Vander Poorten
- Otorhinolaryngology - Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; European Salivary Gland Society, Geneva, Switzerland
| | - Marco Guzzo
- Department of Head and Neck Surgery, Istituto Nazionale dei Tumori, Milan, Italy
| | - Remo Accorona
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy
| | - Vittorio Rampinelli
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy
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17
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Kashiwagi N, Murakami T, Toguchi M, Nakanishi K, Hidaka S, Fukui H, Kimura M, Kitano M, Tomiyama N. Metastases to the parotid nodes: CT and MR imaging findings. Dentomaxillofac Radiol 2016; 45:20160201. [PMID: 27635667 DOI: 10.1259/dmfr.20160201] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To present and characterize CT and MR imaging findings of metastases to the parotid nodes. METHODS CT (n = 10) and MR (n = 11) images from 14 patients with metastases to the parotid nodes were reviewed. The primary tumour sites were the ocular adnexa in five patients, facial skin in four patients, upper aerodigestive tract in four patients and thyroid gland in one patient. CT and MR images were evaluated with emphasis on the size and number of parotid tumours, their location in the parotid gland, the presence of associated clinically pathological cervical nodes or previous history of cervical node metastasis, margin characteristics and the presence of central necrosis. RESULTS A total of 18 tumours were identified in 14 patients, with an average maximal cross-sectional diameter of 19 mm (7-44 mm). 12 patients had a single parotid tumour and 2 patients had unilateral multiple tumours; 12 tumours in 10 patients were located in the parotid tail, 6 tumours in 4 patients were located in the superficial lobe and no tumour was noted in the deep lobe. In the superficial lobe, four of six tumours were located in the pretragal area. Three of nine patients whose primary sites were the ocular adnexa or skin had associated clinically pathological cervical nodes. None of these patients had a previous history of cervical node metastasis. All five patients with other primary sites had associated pathological cervical nodes or a history of such. 11 tumours had well-defined margins and 7 tumours had ill-defined margins. Post-contrast images showed central necrosis in 2 of 11 tumours. CONCLUSIONS Metastases to the parotid nodes tend to present as solitary parotid masses with two preferential sites.
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Affiliation(s)
- Nobuo Kashiwagi
- 1 Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takamichi Murakami
- 1 Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masafumi Toguchi
- 2 Department of Radiology, Ryukyus University Faculty of Medicine, Okinawa, Japan
| | - Katsuyuki Nakanishi
- 3 Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Shojiro Hidaka
- 1 Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hideyuki Fukui
- 1 Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masatomo Kimura
- 4 Department of Pathology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Mutsukazu Kitano
- 5 Department of Otolaryngology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Noriyuki Tomiyama
- 6 Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
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18
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Abstract
Parotidectomy for parotid cancer includes management of primary salivary cancer, metastatic cancer to lymph nodes, and direct extension from surrounding structures or cutaneous malignancies. Preoperative evaluation should provide surgeons with enough information to plan a sound operation and adequately counsel patients. Facial nerve sacrifice is sometimes required; but in preoperative functioning nerves, function should be preserved. Although nerve involvement predicts poor outcome, survival of around 50% has been reported for primary parotid malignancy. Metastatic cutaneous squamous cell carcinoma is a high-grade aggressive histology whereby local control for palliation with extended parotidectomy can be achieved; however, overall survival remains poor.
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Affiliation(s)
- Jennifer R Cracchiolo
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | - Ashok R Shaha
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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19
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Nisa L, Salmina C, Dettmer MS, Arnold A, Aebersold DM, Borner U, Giger R. Implications of intraglandular lymph node metastases in primary carcinomas of the parotid gland. Laryngoscope 2015; 125:2099-106. [DOI: 10.1002/lary.25342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Lluís Nisa
- Department of Otorhinolaryngology-Head & Neck Surgery; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
- Department of Radiation Oncology; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
- Department of Clinical Research; University of Bern; Bern Switzerland
| | - Cinzia Salmina
- Department of Otorhinolaryngology-Head & Neck Surgery; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
| | - Matthias Stephan Dettmer
- Department of Otorhinolaryngology-Head & Neck Surgery; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
- Institute of Pathology; University of Bern; Bern Switzerland
| | - Andreas Arnold
- Department of Otorhinolaryngology-Head & Neck Surgery; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
| | - Daniel Matthias Aebersold
- Department of Radiation Oncology; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
- Department of Clinical Research; University of Bern; Bern Switzerland
| | - Urs Borner
- Department of Otorhinolaryngology-Head & Neck Surgery; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology-Head & Neck Surgery; Inselspital, Bern University Hospital and University of Bern; Bern Switzerland
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21
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Wang S, Lou J, Zhang S, Guo L, Wang K, Ge M. Metastasis of nasopharyngeal carcinoma to parotid lymph nodes: a retrospective study. World J Surg Oncol 2015; 13:1. [PMID: 25622525 PMCID: PMC4429829 DOI: 10.1186/1477-7819-13-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 12/05/2014] [Indexed: 11/30/2022] Open
Abstract
Background Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy. Methods We enrolled 14 NPC patients who had metastatic disease to parotid lymph nodes after IMRT. They received surgical treatment by total parotidectomy with neck dissection, superficial parotidectomy with neck dissection, partial parotidectomy with neck dissection, total parotidectomy, or superficial parotidectomy. Their age, gender, histopathology, clinical findings, and treatment outcome were analyzed. Results After radiotherapy, parotid metastasis represented as uncontrolled disease in three cases and as recurrent disease in 11 cases. All the 14 patients received salvaged surgery successfully. Pathologic findings showed grade 3 in most patients. The follow-up ranged from 11 to 120 months and the overall three- and five-year survival was 49.5% and 37.1%, respectively. Conclusions Metastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis.
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22
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Sönmez Ergün S, Gayretli Ö, Büyükpınarbaşılı N, Yıldız K, Gürses İA, Avşar A, Cavlak M. Determining the number of intraparotid lymph nodes: Postmortem examination. J Craniomaxillofac Surg 2014; 42:657-60. [DOI: 10.1016/j.jcms.2013.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/05/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022] Open
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23
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Yamagata K, Kanno NI, Ito H, Hasegawa S, Yanagawa T, Onizawa K, Bukawa H. Parotid lymph node metastasis in a patient with tongue cancer. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/crcm.2014.31006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Olsen KD, Moore EJ. Deep lobe parotidectomy: clinical rationale in the management of primary and metastatic cancer. Eur Arch Otorhinolaryngol 2013; 271:1181-5. [PMID: 23832259 DOI: 10.1007/s00405-013-2616-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/26/2013] [Indexed: 11/30/2022]
Abstract
Deep lobe parotidectomy is an important management approach for highgrade primary parotid cancers that metastasize to the deep lobe nodes and for cancers that metastasizes to the deep parotid from a site outside the parotid. This paper reviews the rationale for deep lobe parotidectomy with facial nerve preservation for these parotid cancers. Deep lobe parotid involvement was reviewed in 27 patients. Twelve patients had primary parotid tumors that metastasized to the deep lobe, and 15 had tumors outside the parotid that metastasized to deep parotid nodes. Deep lobe parotidectomy should be considered in patients with a highgrade primary parotid tumor, a cancer that metastasizes to a superficial intraparotid node, or a primary parotid malignancy that metastasizes to a superficial parotid node or a neck node.
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Affiliation(s)
- Kerry D Olsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA,
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25
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Oral cavity and oropharynx squamous cell carcinoma with metastasis to the parotid lymph nodes. Oral Oncol 2011; 47:142-4. [DOI: 10.1016/j.oraloncology.2010.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 11/17/2010] [Accepted: 11/18/2010] [Indexed: 11/23/2022]
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26
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Sarioglu S, Pabuççuoglu U, Ecevit C, Ceryan K, Paksoy S, Ada E. Sialometaplasia arising in the ectopic salivary gland ductal inclusions of multiple intraparotid lymph nodes. J Clin Pathol 2005; 57:1335-7. [PMID: 15563681 PMCID: PMC1770497 DOI: 10.1136/jcp.2004.017202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Sialometaplasia, squamous metaplasia of salivary gland lobules, is a benign condition occasionally presenting with lesions clinically simulating malignancy. "Necrotising sialometaplasia", recognised by lobular infarction, necrosis, and simultaneous squamous metaplasia of ducts and acini is a well known condition. There are only a few reports of the "proliferative type of sialometaplasia", which is recognised by a more mature morphology of larger and more irregular metaplastic nests, lacking necrosis. This report describes a unique case of "proliferative sialometaplasia of multiple intraparotid lymph nodes" occurring in a 55 year old woman, presenting with multiple parotid lumps. This interesting case points to the importance of intraparotid lymph nodes as sites for multiple lesions of the parotid region.
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Affiliation(s)
- S Sarioglu
- Department of Pathology, Faculty of Medicine, Dokuz Eylül University, 35340 lzmir, Turkey.
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27
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Dona E, Veness MJ, Cakir B, Morgan GJ. Metastatic cutaneous squamous cell carcinoma to the parotid: the role of surgery and adjuvant radiotherapy to achieve best outcome. ANZ J Surg 2003; 73:692-6. [PMID: 12956783 DOI: 10.1046/j.1445-2197.2003.02737.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Australia has the highest incidence of cutaneous squamous cell carcinoma in the world. The majority of lesions occur in the head and neck with metastases to the parotid gland lymph nodes reflecting an uncommon, but aggressive, manifestation. Parotidectomy +/- neck dissection followed by adjuvant radiotherapy should be considered as best practice. METHODS Between 1983 and 2000, seventy-four patients were treated for metastatic cutaneous squamous cell carcinoma to the parotid with surgery and adjuvant radiotherapy at Westmead Hospital, Sydney. Relevant data were extracted from patient files and a prospectively maintained database. Patterns of relapse and outcome were analysed. RESULTS Median age at diagnosis was 65 years (34-93 years) in 63 men and 11 women. Median follow-up duration was 41 months (12-188 months). All patients underwent parotidectomy with 52 undergoing a simultaneous neck dissection. Twelve patients required sacrifice of the facial nerve (4) or one or more branches (8). All received adjuvant radiotherapy to the parotid region with 56 also receiving radiotherapy to the ipsilateral neck. Despite treatment, 24% developed locoregional recurrence, with a median time to relapse of 7.5 months. The most common site for recurrence was the treated parotid region and upper neck. Most relapsed patients died. No variable independently predicted for locoregional recurrence on multivariate analysis. The 5-year absolute and cause-specific survival rates were 58% and 72%, respectively. CONCLUSION Parotid gland lymph node metastases from cutaneous squamous cell carcinoma are associated with a high rate of recurrence and cause-specific mortality despite current best practice (surgery and high dose adjuvant radiotherapy). The role of more aggressive surgery, altered fractionation or chemotherapy to enhance locoregional control remains unclear.
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Affiliation(s)
- Eddy Dona
- Head and Neck Unit, Westmead Hospital, Sydney, New South Wales, Australia
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28
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Pinheiro AD. Parotid neoplasm: the lump near the mandible? CURRENT SURGERY 2002; 59:509-17. [PMID: 16093185 DOI: 10.1016/s0149-7944(02)00698-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- A Daniel Pinheiro
- Greater Baltimore Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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29
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Pisani P, Krengli M, Ramponi A, Guglielmetti R, Pia F. Metastases to parotid gland from cancers of the upper airway and digestive tract. Br J Oral Maxillofac Surg 1998; 36:54-7. [PMID: 9578259 DOI: 10.1016/s0266-4356(98)90750-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Forty-four cases of parotid metastases were diagnosed and treated in the period 1968-1994. In 10 patients (23%), the primary tumour was sited in the mucosal layer of the upper airway or digestive tract: oropharynx (n=3), larynx (n=3), nasopharynx (n=2), hypopharynx (n=1) and the maxillary sinus (n=1). Histologically, the primary tumour was squamous cell carcinoma in 9 cases and adenocarcinoma in one. One patient received surgical treatment only, two patients surgery and postoperative radiotherapy, one radiotherapy only, four chemotherapy and two symptomatic treatment only. Only one patient is alive, disease-free, 5 years after treatment. The other patients died: six within 1 year, two within 2 years and one within 3 years of diagnosis.
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Affiliation(s)
- P Pisani
- ENT Clinic, Ospedale Maggiore, Novara, Italy
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