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

Objective: To analyze risk factors for neck metastases in patients with par otid carcinomas. Design: Cohort of patients followed up from 1 to 366.2 months at a single i nstitution. Setting: Referral center, private or institutional practice, hospitalized c are. Patients: A total of 145 patients with parotid carcinomas with complete cli nical and pathological information. The histological diagnosis was reviewed according to the World Health Organization classification for salivary gla nd tumors. Intervention: Patients were treated by surgery alone (62 cases) or with pos toperative radiotherapy (83 cases). A neck dissection was performed in 80 p atients. Main Outcome Measure: Rates of neck lymph node metastasis. Univariate and m ultivariate 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=.00 3). By multivariate analysis, histological type (P<.001), T stage (P=.03), and desmoplasia (P=.006) had the highest correlation with lymph node metast asis. Conclusion: The significant risk factors for neck metastasis in parotid car cinoma were histological type (ie, adenocarcinoma, undifferentiated carcino ma, high-grade mucoepidermoid carcinoma, squamous cell carcinoma, and saliv ary duct carcinoma), T stage (T3 and T3), and desmoplasia (severe).