Management of Positive Cervical Lymph Nodes in Parotid Cancer

Abstract

Objective: Assessment the management of positive cervical lymph nodes in parotid cancer. Associated clinical symptoms, histological types, regional lymph node stage (n stage), occult metastasis, neck dissection by level, recurrence, neck irradiation. Methods. We carried out a retrospective analysis of 43 patient’s pathological positive lymph nodes metastatic from parodied cancer, who underwent neck dissection. treated in years 2010-2020, we analyzed the following parameters: age, sex, pT-Status, tumour size, skin invasion, facial nerve palsy, tumour fixation, extraparotid extension, localization, grade, histology, Distribution of T classification was: T3 (60%), and T4 (40%). Results: Mean patient age was 52 years, the most common location of cervical Nodes Met. was level II (72%), then III (49%) then I (42%), then IV (40%) and V (19%). The incidence was highest among patients with (27.9%) mucoepidermoid carcinoma was most common, followed by (14.6%) carcinoma ex-pleomorphic adenoma (9.3%) with acinic cell carcinoma (7%) with squamous cell carcinoma, (11.6%) with adenoid cystic carcinoma, (7.0%) with adenocarcinoma, (7.4%) salivary duct carcinoma, When classified by histological grade, 35% of patients with low/intermediate-grade versus 65.0% high-grade ., Pre-operative fine needle aspiration (83.7%) patients, Post-surgical irradiation was performed in all 43 patients (100%). The resection status (R) was Negative margins R0. (93%), lymphovascular space invasion (44.2%) and (25.6%) had perineural invasion. Skin invasion in (14%) patients, and (4.7%) had regional nodal recurrence (7%) patients with pN1, vs (93%) patients with pN2. Pathologically positive lymph node 4 (range: 1–8 Nodes) lymph nodes harvest 29(range, 23–41 lymph nodes)., Conclusion: modified Radical Neck Dissection with additional radiotherapy should be carried out in patients. Nodes positive parotied cancer especially High histological stage, advanced stage, perineural invasion, positive operative edge, a fixed mass with extra parotid extension facial-nerve paralysis and tumor pain in partied cancer.