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Intraparotid node metastasis affects the long-term survival of patients with resectable recurrent parotid gland carcinoma

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Abstract

Purpose

The recurrence rate of parotid gland cancer is high, but research on the prognosis of recurrent parotid gland cancer (RPC) is relatively limited. We aim to determine the potential prognosis factors of RPC.

Study design

Retrospective cohort analysis.

Setting

Tertiary cancer center.

Methods

We conducted a retrospective review from 2012 to 2021 on RPC patients treated at the China National Cancer Center (CNCC). To analyze the impact of various variables on overall survival (OS) after recurrence, a univariate and multivariate Cox proportional hazard model was employed.

Results

A total of 50/218 (23.0%) patients diagnosed with RPC and underwent surgery. The 5-year OS of all RPC patients in this cohort was 61.9%. 5 of 50 patients (10%) exhibited intraparotid node (IPN) metastasis. By univariate and multivariate analyses, we found that IPN metastasis was one of the prognostic factors of OS (p = 0.039) in RPC patients. The presence of IPN metastasis was also related to poor survival in individuals with negative cervical lymph nodes (CN0) (p = 0.011). In terms of the influence of surgical margins on prognosis, our findings revealed that RPC patients with negative margins exhibited a higher survival result than those with positive margins (p = 0.002).

Conclusion

According to this study, IPN metastasis indicate a high incidence of mortality in recurrent parotid cancer patients. Particularly, in CN0 patients, the presence of IPN metastasis was associated with poor survival in CN0 patients.

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Data availability

Not applicable. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

References

  1. Carlson ER, Schlieve T (2019) Salivary gland malignancies. Oral Maxillofac Surg Clin N Am 31(1):125–144

    Article  Google Scholar 

  2. Speight PM, Barrett AW (2002) Salivary gland tumours. Oral Dis 8(5):229–240

    Article  CAS  PubMed  Google Scholar 

  3. Żurek M, Rzepakowska A, Jasak K et al (2021) The epidemiology of salivary glands pathologies in adult population over 10 years in Poland-cohort study. Int J Environ Res Public Health 19(1):179

    Article  PubMed  PubMed Central  Google Scholar 

  4. Guzzo M, Locati LD, Prott FJ et al (2010) Major and minor salivary gland tumors. Crit Rev Oncol Hematol 74(2):134–148

    Article  PubMed  Google Scholar 

  5. Feinstein TM, Lai SY, Lenzner D et al (2011) Prognostic factors in patients with high-risk locally advanced salivary gland cancers treated with surgery and postoperative radiotherapy. Head Neck 33(3):318–323

    Article  PubMed  PubMed Central  Google Scholar 

  6. Terhaard CH, Lubsen H, Van der Tweel I et al (2004) Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck 26(8):681–692 (discussion 692-3)

    Article  PubMed  Google Scholar 

  7. Lima RA, Tavares MR, Dias FL et al (2005) Clinical prognostic factors in malignant parotid gland tumors. Otolaryngol Head Neck Surg 133(5):702–708

    Article  PubMed  Google Scholar 

  8. Spiro RH (1986) Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg 8(3):177–184

    Article  CAS  PubMed  Google Scholar 

  9. Gillespie MB, Albergotti WG, Eisele DW (2012) Recurrent salivary gland cancer. Curr Treat Options Oncol 13(1):58–70

    Article  PubMed  Google Scholar 

  10. Carrillo JF, Vázquez R, Ramírez-Ortega MC et al (2007) Multivariate prediction of the probability of recurrence in patients with carcinoma of the parotid gland. Cancer 109(10):2043–2051

    Article  PubMed  Google Scholar 

  11. Nisa L, Borner U, Dür C et al (2018) Recurrent parotid gland carcinoma: how effective is salvage surgery? Eur Arch Otorhinolaryngol 275(2):507–513

    Article  PubMed  Google Scholar 

  12. Mannelli G, Comini LV, Sacchetto A et al (2022) Estimating survival after salvage surgery for recurrent salivary gland cancers: systematic review. Head Neck 44(8):1961–1975

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lassche G, van Boxtel W, Ligtenberg MJL et al (2019) Advances and challenges in precision medicine in salivary gland cancer. Cancer Treat Rev 80:101906

    Article  CAS  PubMed  Google Scholar 

  14. Chakrabarti S, Nair D, Malik A et al (2018) Prognostic factors in parotid cancers: Clinicopathological and treatment factors influencing outcomes. Indian J Cancer 55(1):98–104

    Article  PubMed  Google Scholar 

  15. Hu Y, **a L, Zhang C et al (2020) Clinicopathologic features and prognostic factors of widely invasive carcinoma ex pleomorphic adenoma of parotid gland: a clinicopathologic analysis of 126 cases in a Chinese population. J Oral Maxillofac Surg 78(12):2247–2257

    Article  PubMed  Google Scholar 

  16. Liu Y, Su M, Yang Y et al (2017) Prognostic factors associated with decreased survival in patients with acinic cell carcinoma of the parotid gland. J Oral Maxillofac Surg 75(2):416–422

    Article  PubMed  Google Scholar 

  17. Fang Q, Wu J, Liu F (2019) Oncologic outcome and potential prognostic factors in primary squamous cell carcinoma of the parotid gland. BMC Cancer 19(1):752

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lee DY, Park MW, Oh KH et al (2016) Clinicopathologic factors associated with recurrence in low- and high-grade parotid cancers. Head Neck 38(Suppl 1):E1788–E1793

    PubMed  Google Scholar 

  19. Janik S, Faisal M, Marijić B et al (2022) Prognostic factors in mammary analogue secretory carcinomas of the parotid gland: Systematic review and meta-analysis. Head Neck 44(3):792–804

    Article  PubMed  Google Scholar 

  20. Amini A, Waxweiler TV, Brower JV et al (2016) Association of adjuvant chemoradiotherapy vs radiotherapy alone with survival in patients with resected major salivary gland carcinoma: data from the national cancer data base. JAMA Otolaryngol Head Neck Surg 142(11):1100–1110

    Article  PubMed  Google Scholar 

  21. Osborn V, Givi B, Lee A et al (2017) Characterization, treatment and outcomes of salivary ductal carcinoma using the National Cancer Database. Oral Oncol 71:41–46

    Article  PubMed  Google Scholar 

  22. Honda K, Tanaka S, Shinohara S et al (2018) Survival in patients with parotid gland carcinoma - Results of a multi-center study. Am J Otolaryngol 39(1):65–70

    Article  PubMed  Google Scholar 

  23. Dahan LS, Giorgi R, Vergez S et al (2021) Mucoepidermoid carcinoma of salivary glands: a French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 47(6):1376–1383

    Article  PubMed  Google Scholar 

  24. Wei ZG, Peng XC, He Y et al (2021) Survival outcomes in patients with parotid gland carcinoma treated with postoperative therapies using risk stratification. Head Neck 43(8):2488–2496

    Article  PubMed  Google Scholar 

  25. Jia MQ, Gao M, Ye P et al (2022) Survival outcome of salivary gland carcinoma: a 50-year retrospective study with long-term follow-up. J Oral Maxillofac Surg 80(12):2003–2014

    Article  PubMed  Google Scholar 

  26. Conley J, Arena S (1963) Parotid gland as a focus of metastasis. Arch Surg 87:757–764

    Article  CAS  PubMed  Google Scholar 

  27. Batsakis JG (1983) Pathology consultation. Parotid gland and its lymph nodes as metastatic sites. Ann Otol Rhinol Laryngol 92(2):209–210

    Article  CAS  PubMed  Google Scholar 

  28. McKean ME, Lee K, McGregor IA (1985) The distribution of lymph nodes in and around the parotid gland: an anatomical study. Br J Plast Surg 38(1):1–5

    Article  CAS  PubMed  Google Scholar 

  29. Sönmez Ergün S, Gayretli O, Büyükpınarbaşılı N et al (2014) Determining the number of intraparotid lymph nodes: postmortem examination. J Craniomaxillofac Surg 42(5):657–660

    Article  PubMed  Google Scholar 

  30. Klussmann JP, Ponert T, Mueller RP et al (2008) Patterns of lymph node spread and its influence on outcome in resectable parotid cancer. Eur J Surg Oncol 34(8):932–937

    Article  CAS  PubMed  Google Scholar 

  31. Lim CM, Gilbert MR, Johnson JT et al (2014) Clinical significance of intraparotid lymph node metastasis in primary parotid cancer. Head Neck 36(11):1634–1637

    Article  PubMed  Google Scholar 

  32. Nisa L, Salmina C, Dettmer MS et al (2015) Implications of intraglandular lymph node metastases in primary carcinomas of the parotid gland. Laryngoscope 125(9):2099–2106

    Article  PubMed  Google Scholar 

  33. Guntinas-Lichius O, Thielker J, Robbins KT et al (2021) Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: systematic review. Head Neck 43(3):997–1008

    Article  PubMed  Google Scholar 

  34. Stenner M, Molls C, Luers JC et al (2012) Occurrence of lymph node metastasis in early-stage parotid gland cancer. Eur Arch Otorhinolaryngol 269(2):643–648

    Article  PubMed  Google Scholar 

  35. Pisani P, Ramponi A, Pia F (1996) The deep parotid lymph nodes: an anatomical and oncological study. J Laryngol Otol 110(2):148–150

    Article  CAS  PubMed  Google Scholar 

  36. Amin MB, Greene FL, Edge SB et al (2017) The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. Cancer J Clin 67(2):93–99

    Article  Google Scholar 

  37. Seethala RR, Altemani A, Ferris RL et al (2019) Data Set for the reporting of carcinomas of the major salivary glands: explanations and recommendations of the guidelines from the international collaboration on cancer reporting. Arch Pathol Lab Med 143(5):578–586

    Article  CAS  PubMed  Google Scholar 

  38. Sood S, McGurk M, Vaz F (2016) Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol 130(S2):S142-s149

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Olsen KD, Quer M, de Bree R et al (2017) Deep lobe parotidectomy-why, when, and how? Eur Arch Otorhinolaryngol 274(12):4073–4078

    Article  PubMed  Google Scholar 

  40. Niu X, Fang Q, Liu F (2019) Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland. BMC Cancer 19(1):417

    Article  PubMed  PubMed Central  Google Scholar 

  41. Wu J, Fang Q, Liu F et al (2020) Intraparotid node metastases in adults with parotid mucoepidermoid cancer: an indicator of prognosis? Br J Oral Maxillofac Surg 58(5):525–529

    Article  CAS  PubMed  Google Scholar 

  42. Lombardi D, Tomasoni M, Paderno A et al (2021) The impact of nodal status in major salivary gland carcinoma: a multicenter experience and proposal of a novel N-classification. Oral Oncol 112:105076

    Article  PubMed  Google Scholar 

  43. Kouka M, Koehler B, Buentzel J et al (2022) Role of intraparotid and neck lymph node metastasis in primary parotid cancer surgery: a population-based analysis. Cancers (Basel) 14(12):2822

    Article  PubMed  Google Scholar 

  44. Cho JK, Lim BW, Kim EH et al (2016) Low-grade salivary gland cancers: treatment outcomes, extent of surgery and indications for postoperative adjuvant radiation therapy. Ann Surg Oncol 23(13):4368–4375

    Article  PubMed  Google Scholar 

  45. Ghosh-Laskar S, Murthy V, Wadasadawala T et al (2011) Mucoepidermoid carcinoma of the parotid gland: factors affecting outcome. Head Neck 33(4):497–503

    Article  PubMed  Google Scholar 

  46. Zenga J, Parikh AS, Emerick KS et al (2018) Close margins and adjuvant radiotherapy in acinic cell carcinoma of the parotid gland. JAMA Otolaryngol Head Neck Surg 144(11):1011–1016

    Article  PubMed  PubMed Central  Google Scholar 

  47. Richter SM, Friedmann P, Mourad WF et al (2012) Postoperative radiation therapy for small, low-/intermediate-grade parotid tumors with close and/or positive surgical margins. Head Neck 34(7):953–955

    Article  PubMed  Google Scholar 

  48. Haderlein M, Scherl C, Semrau S et al (2016) High-grade histology as predictor of early distant metastases and decreased disease-free survival in salivary gland cancer irrespective of tumor subtype. Head Neck 38(Suppl 1):E2041–E2048

    PubMed  Google Scholar 

  49. Nam SJ, Roh JL, Cho KJ et al (2016) Risk factors and survival associated with distant metastasis in patients with carcinoma of the salivary gland. Ann Surg Oncol 23(13):4376–4383

    Article  PubMed  Google Scholar 

  50. Ali S, Bryant R, Palmer FL et al (2015) Distant metastases in patients with carcinoma of the major salivary glands. Ann Surg Oncol 22(12):4014–4019

    Article  PubMed  PubMed Central  Google Scholar 

  51. Mimica X, McGill M, Hay A et al (2020) Distant metastasis of salivary gland cancer: Incidence, management, and outcomes. Cancer 126(10):2153–2162

    Article  PubMed  Google Scholar 

  52. Benchetrit L, Mehra S, Mahajan A et al (2022) Major salivary gland cancer with distant metastasis upon presentation: patterns, outcomes, and imaging implications. Otolaryngol Head Neck Surg 167(2):305–315

    Article  PubMed  Google Scholar 

  53. Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113(1):37–49

    Article  CAS  PubMed  Google Scholar 

  54. Girelli L, Locati L, Galeone C et al (2017) Lung metastasectomy in adenoid cystic cancer: Is it worth it? Oral Oncol 65:114–118

    Article  PubMed  Google Scholar 

  55. Tchekmedyian V, Sherman EJ, Dunn L et al (2019) Phase II study of lenvatinib in patients with progressive, recurrent or metastatic adenoid cystic carcinoma. J Clin Oncol 37(18):1529–1537

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Fushimi C, Tada Y, Takahashi H et al (2018) A prospective phase II study of combined androgen blockade in patients with androgen receptor-positive metastatic or locally advanced unresectable salivary gland carcinoma. Ann Oncol 29(4):979–984

    Article  CAS  PubMed  Google Scholar 

  57. Takahashi H, Tada Y, Saotome T et al (2019) Phase II trial of trastuzumab and docetaxel in patients with human epidermal growth factor receptor 2-positive salivary duct carcinoma. J Clin Oncol 37(2):125–134

    Article  CAS  PubMed  Google Scholar 

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei**g, People’s Republic of China

    Yixuan Song, Yuqin He, Han Li, Li Zhao, Yang Liu & Shaoyan Liu

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  1. Yixuan Song
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  2. Yuqin He
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  3. Han Li
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  4. Li Zhao
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  5. Yang Liu
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Correspondence to Shaoyan Liu.

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The experimental protocol was established, according to the ethical guidelines of the Helsinki Declaration, and was approved by the Ethics Committee of Cancer Hospital, Chinese Academy of Medical Sciences. Written informed consent was obtained from individual or guardian participants.

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Song, Y., He, Y., Li, H. et al. Intraparotid node metastasis affects the long-term survival of patients with resectable recurrent parotid gland carcinoma. Eur Arch Otorhinolaryngol 280, 5547–5555 (2023). https://doi.org/10.1007/s00405-023-08142-2

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