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Elective neck dissection in adenoid cystic carcinoma of head and neck: yes or no? A systematic review

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

A systematic review of the published literature on cases of elective neck dissection (END) among patients with AdCCHN was performed.

Results

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%.

Conclusions

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.

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Authors and Affiliations

  1. Department of Maxillofacial Surgery, University Hospital Dubrava, University of Zagreb School of Medicine, Ave. Gojko Susak 6, 10000, Zagreb, Croatia

    Ivica Luksic

  2. Department of Radiotherapy and Medical Oncology, University Hospital for Tumours, University Hospital Center “Sisters of Mercy”, Ilica 197, 10000, Zagreb, Croatia

    Petar Suton

Authors
  1. Ivica Luksic
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  2. Petar Suton
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Correspondence to Ivica Luksic.

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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.

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Informed consent was not obtained from individual participants due the fact that this review included retrospective studies for which formal consent was obtained.

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Luksic, I., Suton, P. Elective neck dissection in adenoid cystic carcinoma of head and neck: yes or no? A systematic review. Eur Arch Otorhinolaryngol 276, 2957–2962 (2019). https://doi.org/10.1007/s00405-019-05669-1

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  • DOI: https://doi.org/10.1007/s00405-019-05669-1

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