Elective neck dissection in adenoid cystic carcinoma of head and neck: yes or no? A systematic review
- 162 Downloads
Adenoid cystic carcinoma of head and neck (AdCCHN) is salivary gland malignancy known for its slow progression accompanied with perineural invasion, rare lymphatic spread to the neck, high rate of local recurrence and delayed onset of distant metastases. While local recurrence and distant metastases are most common patterns of relapse and cause of death in AdCCHN, it has been debated whether lymph node involvement affects the course of the disease. The aim of this systematic review was to address this important issue and to recommend guidelines on clinically node-negative neck management in patients with AdCCHN.
A systematic review of the published literature on cases of elective neck dissection (END) among patients with AdCCHN was performed.
This analysis included a total of 5767 AdCCHN patients with 2450 ENDs, ranging from 10 to 1190. Elective lymphadenectomy was employed in 42.5% of patients with AdCCHN (range 9.2–100%). The overall rate of occult neck metastases in patients with AdCCHN was reported to range between 0 and 43.7%, the average being 13.9%.
If performed, END should be limited to levels I–III of the ipsilateral neck since occult metastases are exclusively located within these neck regions. Although END is associated with a prolonged regional recurrence-free period, it influence on final outcome or survival is still controversial. This review strongly supports conduction of prospective trials on indications, prognostic significance and extent of END in AdCCHN.
KeywordsHead neck Adenoid cystic carcinoma Elective neck dissection Occult neck metastasis Survival Recurrence
Compliance with ethical standards
Research involving human participants and/or animals
All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
This is a systematic review on retrospective studies which were conducted on already available data for which formal consent was obtained. Therefore, institutional ethical approval is not required according on the law and the national ethical guidelines.
Informed consent was not obtained from individual participants due the fact that this review included retrospective studies for which formal consent was obtained.
- 1.Ellis GL, Auclair PL (1996) Atlas of tumor pathology: tumors of the salivary glands. Third series fascicles 17. Armed Forces Institute of Pathology, Washington, DC, pp 203–216Google Scholar
- 8.Amit M, Binenbaum Y, Sharma K, Ramer N, Ramer I, Agbetoba A, Miles B, Yang X, Lei D, Bjoerndal K, Godballe C, Mücke T, Wolff KD, Fliss D, Eckardt AM, Copelli C, Sesenna E, Palmer F, Patel S, Gil Z (2013) Adenoid cystic carcinoma of the nasal cavity and paranasal sinuses: a meta-analysis. J Neurol Surg B Skull Base 74:118–125CrossRefGoogle Scholar