Multivariate analysis of risk factors for neck metastases in surgically treated parotid carcinomas

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 T3), and desmoplasia (severe).