Background The aim of the study is to analyze potential prognostic factors and to evaluate therapy strategies regarding clinical outcome in patients with eccrine porocarcinoma (EPC) of the head and neck. Methods One hundred and sixteen EPC cases from ninety studies and four authors' EPC cases were included in the meta‐analysis. Results At an average follow up of 20.48 months, the 3‐year overall survival and regional recurrence rate were 70.3% and 19.0%, respectively. Patients without surgical treatment had a significantly worse 3‐year overall survival. Mohs microscopic surgery led to significantly less occurrence of regional recurrences compared to wide excision. An ulcerating lesion, high mitotic activity, and lymphovascular invasion were significant prognostic factors. Conclusion Surgical resection is the cornerstone in the therapy of EPC and represents the therapeutic modality that offers the best chance of disease‐free survival. Due to the high probability of recurrence, close follow‐ups are strongly recommended.

Because extracapsular dissection led to a significantly higher percentage of permanent facial palsy, recurrent disease, and positive resection margins compared to SP, we recommend SP for treating benign parotid gland tumors. © 2016 Wiley Periodicals, Inc. Head Neck 39: 356-360, 2017.

The objective of this study was to evaluate the clinical outcome of patients with acinic cell carcinomas of the parotid gland after elective neck dissection (END). A retrospective chart review was performed including 66 patients with acinic cell carcinoma of the parotid gland. Clinical parameters were retrieved and statistically analyzed regarding disease-free survival (DFS) and disease-specific survival (DSS). An END was done in 27 (40.9%) patients, and occult metastases were detected in 4 (14.8%) patients of whom three were low-grade carcinoma. Positive neck nodes were associated with significantly worse DSS (p = 0.05). Intermediate and high-grade carcinoma (HR 8.62; 95% confidence interval (CI): 1.69–44.01; p = 0.010), perineural invasion (HR 19.6; 95%CI: 0.01–0.37; p = 0.003) and lymphovascular invasion (HR 10.2; 95%CI: 0.02–0.59; p = 0.011) were worse prognostic factors for DFS. An END should be considered in patients with acinic cell carcinoma of the parotid gland due to (i) a notable rate of occult neck metastases in low-grade tumors and (ii) the worse DSS of patients with positive neck nodes.

Laryngopharyngectomy followed by adjuvant radiotherapy (PORT) or primary radiochemotherapy represents the treatment of choice for locally advanced laryngeal and hypopharyngeal carcinoma. 1 Despite increasing insights into the molecular pathways and constant efforts to improve therapy regimens, the outcome of patients with advanced stage disease remains poor. 2,3 Particularly, 50%-70% of patients with stage III or IV disease will die due to disease 5 years after the diagnosis. 4 Locoregional and distant failure are the major prognostic determinants, and therefore, the primary factor of mortality in this patient population with recurrence rates ranging between 25% and 50%. 5 Regional lymph node metastases, advanced stage disease, surgical resection margin and extracapsular extension are established risk factors for locoregional recurrence or distant metastasis in laryngeal and hypopharyngeal carcinoma. [6][7][8] Nevertheless, identification of new prognostic factors for recurrence is of utmost importance as it may improve treatment strategies and post-therapeutic surveillance.Recently, the lymph node ratio (LNR) has been shown to be an important prognostic factor in bladder, oesophageal and oral squamous cell carcinomas (SCCs). 9-11 LNR is defined as the ratio of positive lymph nodes to the total number of dissected lymph nodes. Although studies have also been performed in patients with laryngeal and hypopharyngeal cancer, the prognostic value of LNR was contradictory because the prognostic power of LNR was not significant for all

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To evaluate the effect of salivary bypass tube (SBT) usage on the occurrence of pharyngocutaneous fistula (PCF) in patients after a laryngopharyngectomy, a total of 20 studies, published between 1988 and 2021, were identified including 2946 patients. We performed a meta-analysis assessing the risk of PCF occurrence in patients after SBT application compared to those without. PCF occurred in 26.8% of cases (669/2496) and SBT was applied in 33.0% of patients (820/2483). There was an overall trend towards lower PCF rates when using SBTs (22.2% vs. 35.3%; p = 0.057). We further selected five studies, comprising 580 patients who underwent laryngopharyngectomies, for meta-analysis showing that application of SBT reduced the risk of PCF formation (OR 0.46; 95% CI 0.18–1.18; p = 0.11). The meta-analysis demonstrates a beneficial effect of SBT insertion on PCF formation in patients after laryngopharyngectomy.

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