International Journal of Clinical Oncology

, Volume 24, Issue 6, pp 624–631 | Cite as

Patterns of lymph node metastasis and the management of neck dissection for parotid carcinomas: a single-institute experience

  • Tsuyoshi Jinnin
  • Ryo KawataEmail author
  • Masaaki Higashino
  • Shuji Nishikawa
  • Tetsuya Terada
  • Shin-Ichi Haginomori
Original Article



There is no consensus about the indications and range of neck dissection in patients who have parotid carcinoma, with elective neck dissection for cN0 disease being particularly controversial.


This study retrospectively reviewed 185 patients with newly diagnosed parotid carcinoma who were treated at our department between September 1999 and August 2018.


50 of the 185 patients had lymph node metastasis, including 7.7%, 12.2%, 36.0%, and 55.8% of patients with T1, T2, T3, and T4 disease, respectively. When classified by histological grade, 5.7% of patients with low/intermediate-grade disease had lymph node metastasis versus 55.0% of patients with high-grade disease. Multivariate analysis revealed that the histological grade and T classification were independent predictors of lymph node metastasis. Occult metastasis was found in 8 out of 73 clinically node negative patients undergoing neck dissection. The most common site of cervical metastasis was level 2, followed by the periparotid nodes, level 3, and level 4.


Elective neck dissection may be most appropriate for parotid carcinoma patients with high grade disease and/or an advanced T classification. Because preoperative evaluation of the histological grade of parotid carcinoma has limited reliability, it is important to decide the indications and range of neck dissection from the results of frozen section biopsy.


Parotid carcinoma Lymph node metastasis Elective neck dissection Occult metastasis Histological grade 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Tsuyoshi Jinnin
    • 1
  • Ryo Kawata
    • 1
    Email author
  • Masaaki Higashino
    • 1
  • Shuji Nishikawa
    • 1
  • Tetsuya Terada
    • 1
  • Shin-Ichi Haginomori
    • 1
  1. 1.Department of Otorhinolaryngology-Head and Neck SurgeryOsaka Medical CollegeTakatsukiJapan

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