Wang Shengye, Lou Jianlin, Zhang Suzhan, Guo Liang, Wang Kejing, Ge Minghua
World J Surg Oncol. 2015 Jan 26;13:1. doi: 10.1186/1477-7819-13-1.
Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy.
We enrolled 14 NPC patients who had metastatic disease to parotid lymph nodes after IMRT. They received surgical treatment by total parotidectomy with neck dissection, superficial parotidectomy with neck dissection, partial parotidectomy with neck dissection, total parotidectomy, or superficial parotidectomy. Their age, gender, histopathology, clinical findings, and treatment outcome were analyzed.
After radiotherapy, parotid metastasis represented as uncontrolled disease in three cases and as recurrent disease in 11 cases. All the 14 patients received salvaged surgery successfully. Pathologic findings showed grade 3 in most patients. The follow-up ranged from 11 to 120 months and the overall three- and five-year survival was 49.5% and 37.1%, respectively.
Metastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis.
恶性腮腺肿瘤是鼻咽癌（NPC）罕见的转移灶。本研究旨在探讨鼻咽癌转移至腮腺淋巴结患者手术治疗后的临床病理特征及预后。
我们纳入了14例在调强放射治疗（IMRT）后出现腮腺淋巴结转移的鼻咽癌患者。他们接受了全腮腺切除加颈部清扫术、浅叶腮腺切除加颈部清扫术、部分腮腺切除加颈部清扫术、全腮腺切除术或浅叶腮腺切除术等手术治疗。对他们的年龄、性别、组织病理学、临床表现及治疗结果进行了分析。
放疗后，3例腮腺转移表现为疾病未控，11例表现为疾病复发。所有14例患者均成功接受了挽救性手术。病理结果显示大多数患者为3级。随访时间为11至120个月，3年和5年总生存率分别为49.5%和37.1%。
鼻咽癌患者在IMRT后应检查是否有腮腺淋巴结转移。对于有颈部转移的患者，建议切除腮腺下极淋巴结；对于腮腺内淋巴结转移患者，建议行浅叶或全腮腺切除术及辅助治疗。
