Parotidectomy in patients with head and neck cutaneous melanoma with cervical lymph node involvement

Head Neck. 2019 Jul;41(7):2264-2270. doi: 10.1002/hed.25670. Epub 2019 Feb 14.

Abstract

Background: Parotidectomy in melanoma of the coronal scalp and face with clinically involved cervical lymph node metastasis is based on predicted cervical lymphatic drainage described by O'Brien.

Methods: In total, 40 parotidectomies with en bloc therapeutic neck dissection were retrospectively analyzed.

Results: Lymphatic spread of melanoma to the parotid lymph nodes was observed in 10 of 40 specimens (25%). Eight of the 10 parotid-positive patients developed a recurrence vs 17 of the 30 parotid-negative patients (P = 0.28). There were no differences in overall survival, melanoma-specific survival, and disease-free survival between the parotid-positive and parotid-negative patients.

Conclusion: Although in this series no survival differences were found, parotidectomy still merits a sustained role in therapeutic neck dissection procedures to improve regional control and to prevent facial nerve damage after surgery for a second relapse from occult metastases in the parotid.

Keywords: head and neck; melanoma; metastasis; parotid gland; parotidectomy.

MeSH terms

  • Adult
  • Aged
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy
  • Humans
  • Lymphatic Metastasis*
  • Male
  • Melanoma / mortality*
  • Melanoma / pathology
  • Melanoma / therapy
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local
  • Parotid Gland / surgery*
  • Retrospective Studies
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy