Affiliation:
1. Head and Neck Institute Cleveland Clinic Cleveland Ohio U.S.A.
2. Department of Otolaryngology ‐ Head and Neck Surgery University Hospitals Cleveland Ohio U.S.A.
3. Department of Radiation Oncology Cleveland Clinic Cleveland Ohio U.S.A.
4. Department of Otolaryngology Cleveland Clinic Florida Vero Beach Florida U.S.A.
Abstract
ObjectivesSalivary gland malignancies comprise a heterogeneous group of pathologies, for which treatment of the clinically negative neck may vary depending on numerous factors. Herein we present data on occult nodal metastases (ONM) as well as survival and recurrence from a large series of cN0 salivary gland malignancies.MethodsRetrospective chart review was conducted on 532 patients, with 389 patients with major salivary gland cancers and 143 patients with minor salivary gland cancers. Demographic and treatment data were included and rates of ONM, overall survival, local recurrence, regional recurrence, and distant recurrence were analyzed.ResultsWe found that the overall rate of ONM for parotid was 27% (63/235), for submandibular/sublingual was 35% (18/52), and for minor was 15% (4/26). Analysis of ONM rate at each nodal level was also performed, finding higher rates of level IV and V ONM than prior studies. Submandibular/sublingual and minor salivary gland malignancies showed a predominance of ONMs at levels I–III. Our survival and recurrence rates were similar to those found in previous studies.ConclusionOur data also demonstrate a predominance of ONM in levels I–III for submandibular/sublingual and minor salivary gland cancers, suggesting elective dissection in these levels.Level of EvidenceLevel IV Laryngoscope, 2023