Varga Regina, Iro Ann-Kristin, Thimsen Vivian, Sievert Matti, Agaimy Abbas, Balk Matthias, Rupp Robin, Grundtner Philipp, Koch Michael, Iro Heinrich, Mantsopoulos Konstantinos
Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Am J Otolaryngol. 2023 Nov-Dec;44(6):103973. doi: 10.1016/j.amjoto.2023.103973. Epub 2023 Jul 5.
The aim of the study was to investigate primary locoregional metastatic behavior in a large sample of various malignant tumors of the parotid gland with varying grades following surgical treatment consisting of complete parotidectomy and neck dissection.
The records of all patients treated for primary malignant tumors of the parotid gland by means of complete parotidectomy and neck dissection between 2007 and 2022 were studied retrospectively.
196 patients formed our study sample (98 females, 98 males). The mean age was 65.7 years (22-101 years). 92 cases presented with low-grade subtypes, 19 with intermediate-grade, and 85 with high-grade carcinomas. The locoregional lymphatic network had been invaded in a total of 66/196 cases (33.6 %). The intraparotid lymph nodes were positive in 54/196 cases (27.5 %) and the cervical lymph nodes in 41/196 cases (20.9 %). In 12 out of the 66 cases with a pN+ status, the neck had been invaded without involvement of the intraparotideal lymph nodes (18.2 %). Male patients tended to suffer from more aggressive carcinomas, and high-grade subtypes presented significantly more frequently as locally advanced tumors. Higher grading was significantly associated with the involvement of the parotid (p < 0.001) and cervical (p < 0.001) lymph nodes. Intermediate and low-grade cases presented similar behavior concerning tumorous invasion of the lymphatic network of the parotid gland (p = 0.522) and the neck (p = 0.467).
The locoregional metastatic potential of parotid malignant tumors depends upon a variety of histopathologic factors, which have to be considered in the decision-making process concerning the management of locoregional lymph nodes.
本研究旨在调查大量不同分级的腮腺恶性肿瘤患者在接受包括全腮腺切除术和颈部清扫术在内的手术治疗后的原发局部区域转移行为。
回顾性研究2007年至2022年间所有接受全腮腺切除术和颈部清扫术治疗腮腺原发性恶性肿瘤的患者记录。
196例患者构成我们的研究样本（98例女性，98例男性）。平均年龄为65.7岁（22 - 101岁）。92例为低级别亚型，19例为中级别，85例为高级别癌。共有66/196例（33.6%）患者的局部区域淋巴网络受到侵犯。196例中有54例（27.5%）腮腺内淋巴结阳性，41例（20.9%）颈部淋巴结阳性。在66例pN +状态的病例中，有12例颈部受到侵犯但腮腺内淋巴结未受累（18.2%）。男性患者往往患有侵袭性更强的癌症，高级别亚型作为局部晚期肿瘤出现的频率显著更高。更高的分级与腮腺（p < 0.001）和颈部（p < 0.001）淋巴结受累显著相关。中级别和低级别病例在腮腺腺体内淋巴网络（p = 0.522）和颈部（p = 0.467）的肿瘤侵犯方面表现出相似的行为。
腮腺恶性肿瘤的局部区域转移潜能取决于多种组织病理学因素，在关于局部区域淋巴结管理的决策过程中必须考虑这些因素。
