Indications and outcomes for elective dissection of level V in primary parotid cancer

Head Neck. 2022 Jun;44(6):1349-1355. doi: 10.1002/hed.27030. Epub 2022 Mar 18.

Abstract

Background: The extent of cervical lymphadenectomy required for primary parotid cancer is not well-established.

Methods: In this retrospective case-control study, 84 patients who underwent primary parotidectomy and neck dissection for primary parotid cancer between 2010 and 2019 were identified and analyzed.

Results: Of the 84 patients, 37 underwent elective level V neck dissection. All six (16.0%) who had occult level V nodes had clinically evident, preoperative anterior cervical metastases, a statistically significant finding. No other clinical factors are correlated with posterior neck involvement. There was no significant difference in disease-free or overall survival for patients with occult level V disease relative to positive lymph nodes in other levels.

Conclusions: Patients with clinically evident anterolateral cervical lymphatic metastases from parotid cancer preoperatively have high rates of occult level V nodes. Level V neck dissection can be avoided in cN0 patients and offered no survival advantage.

Keywords: head and neck cancer; neck dissection; parotid; salivary gland cancer.

MeSH terms

  • Carcinoma* / pathology
  • Case-Control Studies
  • Humans
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Neck Dissection
  • Neoplasm Staging
  • Parotid Neoplasms* / pathology
  • Retrospective Studies