Management of cN0 Low grade mucoepidermoid carcinomas of salivary glands: prospective multicenter study of 152 cases of the French Network of Rare Head and Neck Tumors (REFCOR).

OBJECTIVES The aim of this study was to identify prognostic factors affecting the survival of the low grade Mucoepidermoid carcinomas (MEC) without clinical-radiological lymph node involvement (cN0) at the time of the initial work-up and to determinate the therapeutic strategy for the neck dissection MATERIALS AND METHODS: One hundred and fifty two patients with cN0 low-grade MEC of salivary glands, were prospectively included in the Reseau d'Expertise Francais sur les Cancers ORL Rares (REFCOR, French Network of Rare Head and Neck Tumors) database between 2009 and 2015. Overall survival, disease-free survival and the rate of nodal recurrence were evaluated. RESULTS Seventy five patients had a clinical stage I (49.3%), 38 stage II (25%), 13 stage III (8.6%) and 14 stage IV (9.2%). The main site was the parotid gland (55.3%). One hundred and forty-four patients (94.7%) were treated with tumor removal surgery. Forty-four patients had lymph node dissection (29%), only one had subclinical metastasis (cN0, pN+). The median follow-up was 26 months. The 5-years overall survival rate and the 5-years disease free survival rate were 94% and 84% respectively. The rate of isolated nodal recurrence was 0%. CONCLUSION Our study confirms the excellent survival rate of low grade cN0 MEC salivary glands, with a very low rate of sub-clinical lymph node metastases and lymph node recurrence. Systematic lymph node dissection for cN0 low grade tumors does not seem necessary.