Topography and probability diagram of cervical and intra-parotid lymph node metastasis in parotid gland cancer

IF 4.2 3区 医学 Q2 ONCOLOGY Clinical & Experimental Metastasis Pub Date : 2023-12-11 DOI:10.1007/s10585-023-10244-4
Nayeon Choi, Yung Jee Kang, Junhun Cho, Dongryul Oh, Jaewoo Jeong, Han-Sin Jeong
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Abstract

In parotid gland cancer (PGC), cervical lymph node metastasis (LNM) and intra-parotid LNM are known as significant indicators of poor prognosis. However, the topography of LNM in the affected parotid gland and the lymphatic progression of PGC has never been explored in detail. This was a retrospective analysis of data from 423 patients with previously untreated primary PGC (2005 to 2020), excluding patients with squamous cell carcinoma, lymphoma or metastatic disease in the parotid gland. The pattern of LNM was analyzed by neck sub-level and parotid sub-site. Using the conditional probability of neck level involvement, a probability diagram was plotted on several thresholds to visualize the sequential progression of LNM in PGC. The pattern of LNM progression was found to be similar between low- and high-grade pathology, but the incidence differed significantly (8.0% vs. 45.4%). Intra-parotid LNs and level IIa LNs were the most common sites (57.3% and 61.0%) of LNM in PGC, followed by level III (31.7%), Ib (25.6%), IV (22.0%), IIb (20.7%) and Va (20.7%) LNM. In intra-parotid LNs, the incidence of LNM in the deep parotid LNs was relatively low (9.4%); most intra-parotid LNMs were observed in the superficial parotid (90.6%) and peri-tumoral (in contact with the tumor) (31.3%) LNs. LNM to levels Ia, Vb and contra-lateral LNM occurred only in the very late stage. Our results provide detailed information about LNM progression in PGC at the sub-level and can help clinicians decide the treatment extent, including surgery or radiation.

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腮腺癌颈淋巴结和腮腺内淋巴结转移的地形图和概率图
众所周知,在腮腺癌(PGC)中,颈淋巴结转移(LNM)和腮腺内淋巴结转移是预后不良的重要指标。然而,有关受影响腮腺内淋巴结转移的地形图以及 PGC 的淋巴发展过程的研究却从未详细探讨过。这是一项回顾性分析,研究对象是423名既往未接受过治疗的原发性PGC患者(2005年至2020年),排除了腮腺鳞状细胞癌、淋巴瘤或转移性疾病患者。按颈部亚层和腮腺亚部位分析了LNM的模式。利用颈部受累的条件概率,在几个阈值上绘制了概率图,以直观显示PGC中LNM的顺序进展。结果发现,低级别和高级别病理的 LNM 进展模式相似,但发生率却有显著差异(8.0% 对 45.4%)。腮腺内LNM和IIa级LNM是PGC中最常见的LNM部位(57.3%和61.0%),其次是III级(31.7%)、Ib级(25.6%)、IV级(22.0%)、IIb级(20.7%)和Va级(20.7%)LNM。在腮腺内LNM中,腮腺深层LNM的发生率相对较低(9.4%);大多数腮腺内LNM发生在腮腺浅层(90.6%)和瘤周(与肿瘤接触)LN(31.3%)。Ⅰa、Ⅴb级和对侧LNM仅发生在晚期。我们的研究结果提供了 PGC 亚层 LNM 进展的详细信息,有助于临床医生决定治疗范围,包括手术或放射治疗。
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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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