Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland
ObjectivesTo determine the predictor for occult neck metastases and the role of elective neck dissection (END) in cT3-4N0 parotid adenoid cystic carcinoma (ACC).MethodsPatients with surgically treated parotid ACC were retrospectively enrolled. Predictors of occult neck metastases and the effect of E...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-09-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.935110/full |
| _version_ | 1798001701950586880 |
|---|---|
| author | Junhui Yuan Fan Meng Chunmiao Xu Wenlu Li Shuang Wu Hailiang Li |
| author_facet | Junhui Yuan Fan Meng Chunmiao Xu Wenlu Li Shuang Wu Hailiang Li |
| author_sort | Junhui Yuan |
| collection | DOAJ |
| description | ObjectivesTo determine the predictor for occult neck metastases and the role of elective neck dissection (END) in cT3-4N0 parotid adenoid cystic carcinoma (ACC).MethodsPatients with surgically treated parotid ACC were retrospectively enrolled. Predictors of occult neck metastases and the effect of END on disease specific survival (DSS), overall survival (OS), locoregional control survival (LRC), and distant metastasis free survival (DMS) were analyzed.ResultsOccult neck metastases occurred in 35 (19.7%) of the 178 patients undergoing an END. The tumor stage [p=0.011, 4.215 (1.387–10.435)] and intra-parotid lymph node metastasis [p=0.032, 3.671 (1.693–8.775)] were related to the possibility of occult neck metastases independently. The END group had better 10-year LRC than the observation group (56% vs. 43%, p=0.002) and also better 10-year DMS than the observation group (43% vs. 32%, p<0.001). The two groups had similar 10-year DSS (40% vs. 33%, p=0.230) and OS (31% vs. 23%, p=0.094) rates. Furthermore, the Cox model confirmed that END was independently associated with better LRC rate [p=0.022, 2.576 (1.338–6.476)] and better DMS [p=0.011, 2.343 (1.274–7.462)].ConclusionsOccult neck metastases in cT3-4N0 parotid ACC was not common. A T4 tumor with intra-parotid lymph node metastasis had the highest possibility of occult neck metastases. END had no effect on DSS or OS but significantly decreased the risk of locoregional recurrence and distant metastasis. |
| first_indexed | 2024-04-11T11:40:29Z |
| format | Article |
| id | doaj.art-d7819a7585ae4850a8f890d3bee2cd8f |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T11:40:29Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-d7819a7585ae4850a8f890d3bee2cd8f2022-12-22T04:25:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.935110935110Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid glandJunhui Yuan0Fan Meng1Chunmiao Xu2Wenlu Li3Shuang Wu4Hailiang Li5Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Radiology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Radiology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Stomatology, The Affiliated First Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, ChinaDepartment of Stomatology, The Affiliated First Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, ChinaDepartment of Radiology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, ChinaObjectivesTo determine the predictor for occult neck metastases and the role of elective neck dissection (END) in cT3-4N0 parotid adenoid cystic carcinoma (ACC).MethodsPatients with surgically treated parotid ACC were retrospectively enrolled. Predictors of occult neck metastases and the effect of END on disease specific survival (DSS), overall survival (OS), locoregional control survival (LRC), and distant metastasis free survival (DMS) were analyzed.ResultsOccult neck metastases occurred in 35 (19.7%) of the 178 patients undergoing an END. The tumor stage [p=0.011, 4.215 (1.387–10.435)] and intra-parotid lymph node metastasis [p=0.032, 3.671 (1.693–8.775)] were related to the possibility of occult neck metastases independently. The END group had better 10-year LRC than the observation group (56% vs. 43%, p=0.002) and also better 10-year DMS than the observation group (43% vs. 32%, p<0.001). The two groups had similar 10-year DSS (40% vs. 33%, p=0.230) and OS (31% vs. 23%, p=0.094) rates. Furthermore, the Cox model confirmed that END was independently associated with better LRC rate [p=0.022, 2.576 (1.338–6.476)] and better DMS [p=0.011, 2.343 (1.274–7.462)].ConclusionsOccult neck metastases in cT3-4N0 parotid ACC was not common. A T4 tumor with intra-parotid lymph node metastasis had the highest possibility of occult neck metastases. END had no effect on DSS or OS but significantly decreased the risk of locoregional recurrence and distant metastasis.https://www.frontiersin.org/articles/10.3389/fonc.2022.935110/fulladenoid cystic carcinomaparotid gland malignancyelective neck dissectionobservationsurvival |
| spellingShingle | Junhui Yuan Fan Meng Chunmiao Xu Wenlu Li Shuang Wu Hailiang Li Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland Frontiers in Oncology adenoid cystic carcinoma parotid gland malignancy elective neck dissection observation survival |
| title | Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland |
| title_full | Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland |
| title_fullStr | Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland |
| title_full_unstemmed | Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland |
| title_short | Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland |
| title_sort | occult neck metastases risk factors and the role of elective neck dissection in ct3 4n0 adenoid cystic carcinoma of the parotid gland |
| topic | adenoid cystic carcinoma parotid gland malignancy elective neck dissection observation survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.935110/full |
| work_keys_str_mv | AT junhuiyuan occultneckmetastasesriskfactorsandtheroleofelectiveneckdissectioninct34n0adenoidcysticcarcinomaoftheparotidgland AT fanmeng occultneckmetastasesriskfactorsandtheroleofelectiveneckdissectioninct34n0adenoidcysticcarcinomaoftheparotidgland AT chunmiaoxu occultneckmetastasesriskfactorsandtheroleofelectiveneckdissectioninct34n0adenoidcysticcarcinomaoftheparotidgland AT wenluli occultneckmetastasesriskfactorsandtheroleofelectiveneckdissectioninct34n0adenoidcysticcarcinomaoftheparotidgland AT shuangwu occultneckmetastasesriskfactorsandtheroleofelectiveneckdissectioninct34n0adenoidcysticcarcinomaoftheparotidgland AT hailiangli occultneckmetastasesriskfactorsandtheroleofelectiveneckdissectioninct34n0adenoidcysticcarcinomaoftheparotidgland |