Surgical treatment of the neck in patients with salivary gland carcinoma

Marie Westergaard-Nielsen; Christian Godballe; Jesper Grau Eriksen; Stine Rosenkilde Larsen; Katalin Kiss; Tina Agander; Benedicte Parm Ulhøi; Birgitte Wittenborg Charabi; Tejs Ehlers Klug; Henrik Jacobsen; Jørgen Johansen; Claus Andrup Kristensen; Elo Andersen; Maria Andersen; Kristine Bjørndal

doi:10.1002/hed.26667

Surgical treatment of the neck in patients with salivary gland carcinoma

Marie Westergaard-Nielsen, Christian Godballe, Jesper Grau Eriksen, Stine Rosenkilde Larsen, Katalin Kiss, Tina Agander, Benedicte Parm Ulhøi, Birgitte Wittenborg Charabi, Tejs Ehlers Klug, Henrik Jacobsen, Jørgen Johansen, Claus Andrup Kristensen, Elo Andersen, Maria Andersen, Kristine Bjørndal

11 Citations (Scopus)

Abstract

BACKGROUND: Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines.

METHODS: Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method.

RESULTS: Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases.

CONCLUSION: We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.

Original language	English
Journal	Head and Neck
Volume	43
Issue number	6
Pages (from-to)	1898-1911
Number of pages	14
ISSN	1043-3074
DOIs	https://doi.org/10.1002/hed.26667
Publication status	Published - Jun 2021

Keywords

cervical lymph nodes
neck dissection
regional metastases
salivary gland carcinoma
surgery

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10.1002/hed.26667

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Westergaard-Nielsen, M., Godballe, C., Grau Eriksen, J., Larsen, S. R., Kiss, K., Agander, T., Parm Ulhøi, B., Wittenborg Charabi, B., Ehlers Klug, T., Jacobsen, H., Johansen, J., Kristensen, C. A., Andersen, E., Andersen, M., & Bjørndal, K. (2021). Surgical treatment of the neck in patients with salivary gland carcinoma. Head and Neck, 43(6), 1898-1911. https://doi.org/10.1002/hed.26667

Westergaard-Nielsen, M, Godballe, C, Grau Eriksen, J, Larsen, SR, Kiss, K , Agander, T, Parm Ulhøi, B, Wittenborg Charabi, B, Ehlers Klug, T, Jacobsen, H, Johansen, J, Kristensen, CA, Andersen, E, Andersen, M & Bjørndal, K 2021, 'Surgical treatment of the neck in patients with salivary gland carcinoma', Head and Neck, vol. 43, no. 6, pp. 1898-1911. https://doi.org/10.1002/hed.26667

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title = "Surgical treatment of the neck in patients with salivary gland carcinoma",

abstract = "BACKGROUND: Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines.METHODS: Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method.RESULTS: Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases.CONCLUSION: We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.",

keywords = "cervical lymph nodes, neck dissection, regional metastases, salivary gland carcinoma, surgery",

author = "Marie Westergaard-Nielsen and Christian Godballe and {Grau Eriksen}, Jesper and Larsen, {Stine Rosenkilde} and Katalin Kiss and Tina Agander and {Parm Ulh{\o}i}, Benedicte and {Wittenborg Charabi}, Birgitte and {Ehlers Klug}, Tejs and Henrik Jacobsen and J{\o}rgen Johansen and Kristensen, {Claus Andrup} and Elo Andersen and Maria Andersen and Kristine Bj{\o}rndal",

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AU - Westergaard-Nielsen, Marie

AU - Godballe, Christian

AU - Grau Eriksen, Jesper

AU - Larsen, Stine Rosenkilde

AU - Kiss, Katalin

AU - Agander, Tina

AU - Parm Ulhøi, Benedicte

AU - Wittenborg Charabi, Birgitte

AU - Ehlers Klug, Tejs

AU - Jacobsen, Henrik

AU - Johansen, Jørgen

AU - Kristensen, Claus Andrup

AU - Andersen, Elo

AU - Andersen, Maria

AU - Bjørndal, Kristine

PY - 2021/6

Y1 - 2021/6

N2 - BACKGROUND: Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines.METHODS: Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method.RESULTS: Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases.CONCLUSION: We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.

AB - BACKGROUND: Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines.METHODS: Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method.RESULTS: Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases.CONCLUSION: We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.

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KW - neck dissection

KW - regional metastases

KW - salivary gland carcinoma

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DO - 10.1002/hed.26667

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SN - 1043-3074

VL - 43

SP - 1898

EP - 1911

JO - Head and Neck

JF - Head and Neck

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ER -

Surgical treatment of the neck in patients with salivary gland carcinoma

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