Deep Parotid Lymph Node Metastasis Is Associated With Recurrence in High-Grade Mucoepidermoid Carcinoma of the Parotid Gland.

PURPOSE: The goal of the present study was to assess the association between intraparotid lymph node (IPN) metastasis and prognosis in high-grade mucoepidermoid carcinoma (MEC) of the parotid gland. PATIENTS AND METHODS: Patients with surgically treated primary high-grade MEC of the parotid gland were retrospectively enrolled. The association between IPN metastasis and clinicopathologic variables was analyzed using chi(2) tests, and recurrence-free survival (RFS) rate was calculated by the Kaplan-Meier method; independent prognostic factors were evaluated by the Cox proportional hazards method. RESULTS: IPN metastasis was noted in 59 patients (48.4%), including 19 cases in the deep lobe and 47 cases in the superficial lobe of the parotid gland. IPN metastasis was statistically related to tumor stage and node stage regardless of the location of the metastasis in the deep or superficial lobe. Patients with superficial and deep lymph node metastasis had a low 5-year RFS rate of 11%. Cox model analysis reported that the status of IPN metastasis was an independent risk factor for recurrence. CONCLUSIONS: IPN metastasis substantially decreases the RFS rate, especially when there is lymph node metastasis in the deep lobe of the parotid gland.