OP146: Significance of the treatment of lymph node metastases in salivary gland malignancy

Aims Lymphatic spread in the reported overall incidence of clinically positive lymph node for salivary gland malignancy is between 9% and 18%. Generally, the type of neck dissection is determined by the clinical extent of the nodal disease still with disputatious surgical and histological dogmas. Material and methods The clinical course of 126 patients with malignant salivary gland tumors surgically treated on our clinic in eight year period was evaluated for the study. Routine diagnostic work-up for salivary gland neoplasms was performed, followed by accurate choice of radical surgery, consequent staging and reconstructions. Results The analyze of entire group was concerned on the results delivered from statistical evaluation of data about localization, delay of the symptoms prior surgery, clinical symptoms, surgery performed, staging, recurrence and cumulative survival time. High-grade carcinomas were found in 36% and about 64% were considered as a low-grade and intermediate-grade of malignancy. Overall incidence of clinical lymph node metastases was confirmed in 16%. Higher incidence was for high-grade adenoid-cystic carcinomas, high grade acinic cell carcinomas and undifferentiated carcinomas. Adequate staging and cumulative survival figure are accomplishing the results. Conclusions Exact preoperative assessment, staging and radical primary surgery are crucial for achieving better local control and survival rates. An elective treatment of the cervical lymph nodes is appropriate only when the risk for occult metastases is high on the basis of certain clinical and histological characteristics of the primary tumor with exact preoperative assessment.