Outcomes of N0 Necks in Primary Parotid Carcinoma: A Multi-Institution Study Over Ten Years
- Harriet Cunniffe 1, Jeremy Wong 2, Richard Jackson 3, Belen Kornfeld 4, Alfred Addison 2, Katerina Karamali 5, Brian Fish 1, Ramez Nassif 2
- 1Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
- 2Department of Ears, Nose and Throat, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK.
- 3Department of Ear, Nose and Throat, Leeds Teaching Hospitals, Leeds, UK.
- 4St Vincent's Hospital, Darlinghurst, Sydney, Australia.
- 5Imperial College Healthcare NHS Trust, London, UK.
- 0Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
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July 15, 2025
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View abstract on PubMed
Summary
This summary is machine-generated.Occult nodal disease is uncommon in parotid cancer patients with N0 necks, but high-grade tumors increase recurrence risk. Elective neck treatment may benefit some patients, warranting further investigation.
Area Of Science
- Oncology
- Head and Neck Surgery
- Pathology
Background
- Parotid carcinoma is a rare malignancy.
- The management of the N0 neck in parotid carcinoma remains controversial.
- Accurate staging is crucial for appropriate treatment planning.
Purpose Of The Study
- To assess the rate of occult nodal positivity in patients with clinical and radiological N0 necks undergoing parotid carcinoma treatment.
- To evaluate outcomes following elective neck dissection with or without radiotherapy.
- To identify factors predicting recurrence and mortality in this patient cohort.
Main Methods
- Retrospective analysis of 134 patients diagnosed with parotid malignancy between 2007 and 2018.
- Data collected from three UK tertiary cancer centers.
- Inclusion criteria: clinical and radiological N0 neck status.
Main Results
- 6% (4/62) of patients with radiologically N0 necks had positive lymph nodes following neck dissection.
- No statistically significant factors were associated with recurrence or disease-related mortality.
- Recurrence of the disease was associated with an increased risk of mortality (HR 1.444).
Conclusions
- The rate of occult nodal disease in N0 parotid malignancy is low.
- High-grade parotid tumors are associated with a higher risk of nodal disease and recurrence.
- Elective neck treatment may be beneficial for select patients, but further prospective studies are needed.
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