de Brito Santos et al identified risk factors associated with cervical lymph node metastases in a patient with parotid carcinoma. These can help identify patients who may require more aggressive management and monitoring. The authors are from the University of Sao Paulo and Centro de Tratamento e Pesquisa Hospital do Cancer in Sao Paulo, Brazil.
Parameters:
(1) histologic type
(2) T stage from the TNM classification
(3) degree of desmoplasia
|
Histologic Type |
Risk |
|
adenoid cystic carcinoma |
low (< 20%) |
|
low or intermediated grade mucoepidermoid carcinoma |
low (< 20%) |
|
acinic cell carcinoma |
moderate (20 - 50%) |
|
malignant mixed tumor |
moderate (20 - 50%) |
|
myoepithelial cell carcinoma |
moderate (20 - 50%) |
|
other |
moderate (20 - 50%) |
|
adenocarcinoma |
high (> 50%) |
|
undifferentiated carcinoma |
high (> 50%) |
|
high-grade mucoepidermoid carcinoma |
high (> 50%) |
|
squamous cell carcinoma |
high (> 50%) |
|
salivary duct carcinoma |
highest (86%) |
after Table 2, page 58
|
Parameter |
Finding |
Risk |
|
T stage |
T0 |
low |
|
|
T1 |
low |
|
|
T2 |
low |
|
|
T3 |
moderate |
|
|
T4 |
moderate |
|
desmoplasia |
none or minimal |
low |
|
|
moderate |
low |
|
|
severe |
moderate |
where:
• Low risk was associated with an odds ratio of 1.0; moderate risk had an odds ratio 3.7 to 4.9; high risk had an odds ratio of 17.
The different patterns of possible risk factors are:
|
Low |
Moderate |
High |
Overall Risk |
|
3 |
0 |
0 |
low |
|
2 |
1 |
0 |
moderate |
|
2 |
0 |
1 |
high |
|
1 |
1 |
1 |
very high |
|
1 |
2 |
0 |
moderate to high |
|
0 |
2 |
1 |
very high |
|
0 |
3 |
0 |
high |
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
