The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma

Publication date: Available online 22 November 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Kai Qian, Kai Guo, Xiaoke Zheng, Wenyu Sun, Tuanqi Sun, Lili Chen, Ding Ma, Yi Wu, Qinghai Ji, Zhuoying Wang

Summary

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.

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