Abstract：
OBJECTIVE: To determine the indications for neck dissection in the management of parotid, submandibular or minor salivary gland cancers depending on the clinical situation: i.e., clinical lymph node involvement (cN+) or not (cN0); low or high risk of occult nodal metastasis; diagnosis of malignancy before, during or after surgery.
METHODS: The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method.
RESULTS: In cN+ salivary gland cancer, ipsilateral neck dissection is recommended. In cN0 salivary gland cancer, ipsilateral neck dissection is recommended, except for tumors at low risk of occult nodal metastasis. If definitive pathology reveals a high risk of occult nodal involvement, additional neck treatment is recommended: ipsilateral neck dissection or elective nodal irradiation.
CONCLUSIONS: The rate of occult lymph node involvement, and therefore the indication for elective neck dissection, depends primarily on the pathologic grade of the salivary gland cancer.
METHODS: The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method.
RESULTS: In cN+ salivary gland cancer, ipsilateral neck dissection is recommended. In cN0 salivary gland cancer, ipsilateral neck dissection is recommended, except for tumors at low risk of occult nodal metastasis. If definitive pathology reveals a high risk of occult nodal involvement, additional neck treatment is recommended: ipsilateral neck dissection or elective nodal irradiation.
CONCLUSIONS: The rate of occult lymph node involvement, and therefore the indication for elective neck dissection, depends primarily on the pathologic grade of the salivary gland cancer.
摘要：
目的：确定颈清扫术治疗腮腺的适应症，视临床情况而定的颌下腺或小唾液腺癌：即，临床淋巴结受累(cN+)与否(cN0);隐匿性淋巴结转移的低风险或高风险;恶性肿瘤的诊断前,在手术期间或之后。
方法：法国罕见头颈部肿瘤网络（REFCOR）成立了一个指导小组，该小组对Medline上发表的文献进行了叙述性综述，并提出了建议。然后由评级小组根据正式的共识方法评估对建议的遵守程度。
结果：在cN+唾液腺癌，建议同侧颈清扫术。在cN0唾液腺癌中，建议同侧颈淋巴结清扫术，除了隐匿性淋巴结转移风险低的肿瘤。如果明确的病理学显示隐匿性淋巴结受累的风险很高，建议额外的颈部治疗：同侧颈淋巴结清扫术或选择性淋巴结照射。
结论：隐匿性淋巴结受累率，因此选择性颈清扫术的适应症，主要取决于唾液腺癌的病理分级。
方法：法国罕见头颈部肿瘤网络（REFCOR）成立了一个指导小组，该小组对Medline上发表的文献进行了叙述性综述，并提出了建议。然后由评级小组根据正式的共识方法评估对建议的遵守程度。
结果：在cN+唾液腺癌，建议同侧颈清扫术。在cN0唾液腺癌中，建议同侧颈淋巴结清扫术，除了隐匿性淋巴结转移风险低的肿瘤。如果明确的病理学显示隐匿性淋巴结受累的风险很高，建议额外的颈部治疗：同侧颈淋巴结清扫术或选择性淋巴结照射。
结论：隐匿性淋巴结受累率，因此选择性颈清扫术的适应症，主要取决于唾液腺癌的病理分级。
