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Izandro Régis de Brito Santos, MD; Luiz P. Kowalski, MD, PhD; Vera Cavalcante de Araujo, DDS, PhD; Angela Flávia Logullo, MD, PhD; José Magrin, MD, PhD

Arch Otolaryngol Head Neck Surg. 2001;127:56-60.

Objective  To analyze risk factors for neck metastases in patients with parotid carcinomas.

Design  Cohort of patients followed up from 1 to 366.2 months at a single institution.

Setting  Referral center, private or institutional practice, hospitalized care.

Patients  A total of 145 patients with parotid carcinomas with complete clinical and pathological information. The histological diagnosis was reviewed according to the World Health Organization classification for salivary gland tumors.

Intervention  Patients were treated by surgery alone (62 cases) or with postoperative radiotherapy (83 cases). A neck dissection was performed in 80 patients.

Main Outcome Measure  Rates of neck lymph node metastasis. Univariate and multivariate analyses were carried out using logistic regression evaluating the significance of demographic, clinical, and pathological data.

Results  The following variables were significantly associated to the risk of lymph node metastasis by univariate analysis: histological type (P<.001), T stage (P<.001), desmoplasia (P = .001), facial palsy (P = .02), perineural invasion (P = .01), extraparotid tumor extension (P = .02), and necrosis (P = .003). By multivariate analysis, histological type (P<.001), T stage (P = .03), and desmoplasia (P = .006) had the highest correlation with lymph node metastasis.

Conclusion  The significant risk factors for neck metastasis in parotid carcinoma were histological type (ie, adenocarcinoma, undifferentiated carcinoma, high-grade mucoepidermoid carcinoma, squamous cell carcinoma, and salivary duct carcinoma), T stage (T3 and T4), and desmoplasia (severe).

From the Medical School (Drs Régis de Brito Santos and Flávia Logullo) and the Department of Oral Pathology, School of Dentistry (Dr Cavalcante de Araujo), University of São Paulo, and the Department of Head and Neck Surgery and Otorhinolaryngology, Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo (Drs Kowalski and Magrin), São Paulo, Brazil.

Reprints: Luiz P. Kowalski, MD, PhD, Department of Head and Neck Surgery and Otorhinolaryngology, Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo, R. Professor Antonio Prudente, 211, 01509-010–São Paulo-SP, Brazil (e-mail: lp_kowalski{at}uol.com.br).

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