An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid gland

ABSTRACT

Introduction: Management of clinically negative neck (cN0) in patients with parotid gland cancer is controversial. Treatment options can include observation, elective neck dissection or elective radiotherapy.

Areas covered: We addressed the treatment options for cN0 patients with parotid gland cancer. A literature review was undertaken to determine the optimal management of this group of patients.

Expert opinion: Patients with parotid carcinoma and clinically negative neck have various options for their management. The analysis of tumor stage, histology and grade is essential to better define patients at risk for occult lymph node metastasis. These patients can be managed by surgery, radiotherapy or their combination, depending on the presence of risk factors, the moment at which such risk factors are detected, patient-related clinical conditions, medical provider expertise and institutional facilities.

KEYWORDS:

• Salivary gland
• parotid gland
• neck dissection
• elective neck treatment
• radiotherapy

Article highlights

• This article reviews current options for the management of cN0 parotid cancer patients.

• Currently, there is no strong evidence indicating superiority for any of the treatment options based on the outcomes of locoregional control.

• Elective neck dissection is usually performed when risk factors for occult lymph node metastasis are detected at the pre- or intraoperative setting.

• Elective neck radiotherapy is a valuable option for patients whose malignancy and/or high-risk factors for occult lymph node metastasis are detected after surgery and for patients who have poor performance status.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.