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Expert Review of Anticancer Therapy Volume 19, 2019 - Issue 10
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Review

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

Jose Guilherme Vartaniana Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Sao Paulo, BrazilCorrespondence[email protected]
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Joao Gonçalves Filhoa Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Sao Paulo, BrazilView further author information
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Luiz Paulo Kowalskia Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Sao Paulo, BrazilView further author information
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Jatin P. Shahb Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USAView further author information
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Carlos Suárezc Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain;d Servicio de Otorrinolaringología, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, SpainView further author information
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Alessandra Rinaldoe University of Udine School of Medicine, UdineView further author information
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Remco De Breef Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsView further author information
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Juan P Rodrigog Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto de Oncología de Asturias, University of Oviedo, Centro de Investigación Biomédica en Red de Cáncer, Oviedo, SpainView further author information
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Marc Hamoirh Department of Head & Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, BelgiumView further author information
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Robert P. Takesi Department of Otorhinolaryngology - Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The NetherlandsView further author information
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Antti A. Mäkitiej Faculty of Medicine, University of Helsinki, Research Programme in Systems Oncology, Helsinki, Finland;k Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden;l Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandORCID Iconhttps://orcid.org/0000-0002-0451-2404View further author information
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Peter Zbärenm Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Berne, SwitzerlandView further author information
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Simon Andreasenn Department of Otolaryngology Head & Neck Surgery and Audiology and Department of Pathology Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark;o Department of Otolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, DenmarkView further author information
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Vincent Vander Poortenp Multidisciplinary Salivary Gland Society, Geneva, Switzerland;q Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, section Head and Neck Oncology, University Hospitals Leuven, Leuven, BelgiumView further author information
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Alvaro Sanabriar Department of Surgery, School of Medicine, Clinica Vida, Universidad de Antioquia, Medellín, ColombiaView further author information
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Henrik Hellquists Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, PortugalView further author information
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K. Thomas Robbinst Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, USAView further author information
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Carsten C. Bödekeru Department of Otorhinolaryngology-Head and Neck Surgery, HELIOS Hanseklinikum, Stralsund, GermanyView further author information
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Carl Silverv Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ, USAView further author information
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Alfio Ferlitow Coordinator of the International Head and Neck Scientific Group, Padua, ItalyView further author information
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Pages 899-908 | Received 18 Jun 2019, Accepted 26 Sep 2019, Published online: 08 Oct 2019
 
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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.

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.

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