Metastasis of nasopharyngeal carcinoma to parotid lymph nodes: a retrospective study

World Journal of Surgical Oncology

Minghua Ge¹  Kejing Wang¹  Liang Guo¹  Suzhan Zhang²  Jianlin Lou¹  Shengye Wang³ 

[1] Department of Head and Neck Surgery, Zhejiang Cancer Hospital, 38# Guangji Road, Hangzhous 310022, China;Department of Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, 88# Jiefang Road, Hangzhou 310009, China;Department of Radiation Oncology, Zhejiang Cancer Hospital, 38# Guangji Road, Hangzhou 310022, China

关键词: Neck dissection;    Nasopharyngeal carcinoma;    Parotid node metastasis;   

Others  :  1146567
DOI  :  10.1186/1477-7819-13-1

 received in 2014-08-30, accepted in 2014-12-05,  发布年份 2015

【 摘 要 】

Background

Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy.

Methods

We enrolled 14 NPC patients who had metastatic disease to parotid lymph nodes after IMRT. They received surgical treatment by total parotidectomy with neck dissection, superficial parotidectomy with neck dissection, partial parotidectomy with neck dissection, total parotidectomy, or superficial parotidectomy. Their age, gender, histopathology, clinical findings, and treatment outcome were analyzed.

Results

After radiotherapy, parotid metastasis represented as uncontrolled disease in three cases and as recurrent disease in 11 cases. All the 14 patients received salvaged surgery successfully. Pathologic findings showed grade 3 in most patients. The follow-up ranged from 11 to 120 months and the overall three- and five-year survival was 49.5% and 37.1%, respectively.

Conclusions

Metastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis.

【 授权许可】

   
2015 Wang et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Antonio JK, Santini S, Politi D, Sulfaro S, Spaziante R, Alberti A et al.. Sentinel lymph node biopsy in squamous cell carcinoma of the head and neck: 10 years of experience. Acta Otorhinolaryngol Ital. 2012; 32:18-25.
• [2]Sanders JG, Smith KG, Jameson MB, de Groot C, White J. Persistent neck disease after chemoradiation for head and neck squamous cell carcinoma. J Laryngol Otol. 2012; 126:1121-6.
• [3]Nuyens M, Schüpbach J, Stauffer E, Zbären P. Metastatic disease to the parotid gland. Otolaryngol Head Neck Surg. 2006; 135:844-8.
• [4]Stenner M, Molls C, Luers JC, Beutner D, Klussmann JP, Huettenbrink KB. Occurrence of lymph node metastasis in early-stage parotid gland cancer. Eur Arch Otorhinolaryngol. 2012; 269:643-8.
• [5]Ord RA, Ward-Booth RP, Avery BS. Parotid lymph node metastases from primary intra-oral squamous carcinomas. Int J Oral Maxillofac Surg. 1989; 18:104-6.
• [6]Pisani P, Ramponi A, Pia F. The deep parotid lymph nodes: an anatomical and oncological study. J Laryngol Otol. 1996; 110:148-50.
• [7]Prins-Braam PM, Raaijmakers CP, Terhaard CH. Location of cervical lymph node metastases in oropharyngeal and hypopharyngeal carcinoma: implications for cranial border of elective nodal target volumes. Int J Radiat Oncol Biol Phys. 2004; 58:132-8.
• [8]Olsen SM, Moore EJ, Koch CA, Kasperbauer JL, Olsen KD. Oral cavity and oropharynx squamous cell carcinoma with metastasis to the parotid lymph nodes. Oral Oncol. 2011; 47:142-4.
• [9]Batsakis JG. Parotid gland and its lymph nodes as metastatic sites. Ann Otol Rhinol Laryngol. 1983; 92:209-10.
• [10]Harada H, Omura K. Metastasis of oral cancer to the parotid node. Eur J Surg Oncol. 2009; 35:890-4.
• [11]Garatea-Crelgo J, Gay-Escoda C, Bermejo B, Buenechea-Imaz R. Morphological study of the parotid lymph nodes. J Craniomaxillofac Surg. 1993; 21:207-9.
• [12]O’Hara J, Ferlito A, Takes RP, Rinaldo A, Strojan P, Shaha AR et al.. Cutaneous squamous cell carcinoma of the head and neck metastasizing to the parotid gland–a review of current recommendations. Head Neck. 2011; 33:1789-95.
• [13]Khurana VG, Mentis DH, O’Brien CJ, Hurst TL, Stevens GN, Packham NA. Parotid and neck metastasis from cutaneous squamous cell carcinoma of the head and neck. Am J Surg. 1995; 170:446-50.
• [14]Chua MS, Veness MJ, Morgan G, Shakespeare T, Hehir A, Gebski V et al.. Parotid lymph node metastasis from cutaneous squamous cell carcinomas: treatment outcome and prognostic factors following surgery and adjuvant radiotherapy. Australas Radiol. 2002; 46:174-9.
• [15]Rudzianskas V, Inciura A, Juozaityte E, Rudzianskiene M, Kubilius R, Vaitkus S et al.. Reirradiation of recurrent head and neck cancer using high-dose-rate brachytherapy. Acta Otorhinolaryngol Ital. 2012; 32:297-303.