Presented in part at the 4th World Congress of the International Federation of Head and Neck Oncologic Societies (IFHNOS 2010), Seoul, South Korea, June 15–19, 2010.
Head and Neck
Article first published online: 26 APR 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 7, pages 1497–1506, July 2012
How to Cite
Wang, Y.-L., Li, D.-S., Gan, H.-L., Lu, Z.-W., Li, H., Zhu, G.-P., Huang, C.-P., Zhu, Y.-X., Chen, T.-Z., Wang, Y., Sun, G.-H., Wang, Z.-Y., Shen, Q., Wu, Y. and Ji, Q.-H. (2012), Predictive index for lymph node management of major salivary gland cancer. The Laryngoscope, 122: 1497–1506. doi: 10.1002/lary.23227
Yu-Long Wang and Qing-Hai Ji were supported by National Science Foundation of China (30872958, 81001204). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 21 JUN 2012
- Article first published online: 26 APR 2012
- Accepted manuscript online: 1 FEB 2012 01:18AM EST
- Manuscript Accepted: 9 JAN 2012
- Manuscript Revised: 26 DEC 2011
- Manuscript Received: 30 SEP 2011
- Salivary gland cancer;
- lymph node;
- predictive index;
- neck dissection;
- Level of Evidence: 2b
To find the risk factors of lymph node (LN) metastasis of salivary gland cancer and draw a scheme for LN management.
Hospital-based retrospective study.
The records of salivary gland cancer patients treated at the Department of Head and Neck Surgery, Cancer Hospital, Fudan University, were entered in a database, and 219 consecutive patients with carcinomas of major salivary glands primarily operated on between January 1998 and January 2011 were chosen for univariate and multivariate analysis to identify risk factors for LN involvement.
Fifty-eight (26.5%) patients had LN involvement. Factors associated with cervical LN involvement on univariate analysis included pathologic type, male sex, shorter duration of preoperative course, facial paralysis, advanced T stage, and major nerve, soft tissue, lymphatic/vascular (L/V), neural/perineural, and extracapsular invasion. Multivariate analysis identified major nerve invasion, histologic type, L/V invasion, and extracapsular invasion as significant factors for LN involvement. The proportion of patients with LN involvement with low (105), middle (61), high (34), and super high (19) predictive index scores based on the four risk factors were 3.8%, 27.9%, 55.9%, and 94.7%, respectively.
A predictive index using the clinicopathologic factors described in this report can effectively stratify patients into risk groups for nodal metastasis. Comprehensive management based on this risk index should improve treatment outcomes for patients with salivary gland cancer.