{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:50:12Z","timestamp":1791625812143,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical lymph node metastasis is a major adverse prognostic factor in primary parotid gland malignancies. However, the incidence, level\u2010specific distribution, and independent predictors of nodal metastasis remain incompletely defined in large contemporary multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective longitudinal multicenter study was conducted across 17 tertiary referral centers. Adult patients with histopathologically confirmed primary parotid gland carcinoma who underwent parotidectomy with concurrent neck dissection were included. The primary outcome was pathologically confirmed cervical lymph node metastasis. Secondary outcomes included level\u2010specific nodal distribution, identification of independent risk factors, overall survival (OS), and disease\u2010specific survival (DSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 380 patients were included. Pathological cervical lymph node metastasis was identified in 94 patients (24.7%). Metastases most frequently involved Level II (IIa 17.1%; IIb 11.1%). Salivary duct carcinoma demonstrated the highest rate of nodal metastasis (58.7%). On multivariate analysis, high histological grade and lymphovascular invasion (LVI) were independent predictors of nodal metastasis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Five\u2010year OS for the entire cohort was 64.4%. Patients with nodal metastasis had significantly worse survival compared with node\u2010negative patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cervical lymph node metastasis occurs in approximately one\u2010quarter of surgically staged primary parotid gland malignancies and predominantly involves Levels II\u2013III. High\u2010grade histology and LVI independently predict nodal involvement. These findings support a risk\u2010adapted approach to elective neck management based on histological and pathological risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70320","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:33:59Z","timestamp":1779248039000},"page":"3072-3082","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Cervical Metastasis in Primary Parotid Gland Malignancies: A Yo\u2010\n                    <scp>IFOS<\/scp>\n                    Multicenter Retrospective Longitudinal Study"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9454-9464","authenticated-orcid":false,"given":"Carlos M.","family":"Chiesa\u2010Estomba","sequence":"first","affiliation":[{"name":"Otorhinolaryngology\u2014Head and Neck Surgery Department Donostia University Hospital  St. Sebastian Spain"},{"name":"Head and Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies (YO\u2010IFOS)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kalfert","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine Charles University and University Hospital Motol and Homolka  Prague Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Palacios\u2010Garcia","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology\u2014Head and Neck Surgery Department Macarena University Hospital  Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Tel","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Department, Head and Neck and Neuroscience Department University Hospital of Udine  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Angelo","family":"Vaira","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy University of Sassari  Sassari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-0185","authenticated-orcid":false,"given":"Antonino","family":"Maniaci","sequence":"additional","affiliation":[{"name":"Head and Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies (YO\u2010IFOS)  Paris France"},{"name":"Department of Medicine and Surgery University Enna Kore  Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Silva\u2010Figueroa","sequence":"additional","affiliation":[{"name":"Universidad Finis Terrae\u2014Head and Neck Surgery Department Complejo Asistencial Barros Luco Trudeau  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Boscolo\u2010Rizzo","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences, Section of Otolaryngology University of Trieste  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Salzano","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences University Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Consorti","sequence":"additional","affiliation":[{"name":"Division of Maxillofacial Surgery, Department of Neurological Sciences Marche University Hospitals\u2010Umberto I  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Necati","family":"Enver","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Marmara University Pendik Training and Research Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Dequanter","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery CHU Saint\u2010Pierre, Universit\u00e9 libre de Bruxelles (ULB)  Brussels Belgium"},{"name":"Laboratory of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy Research Institute for Health Sciences and Technology, University of Mons (UMONS)  Mons Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Melkane","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Hotel Dieu de France Hospital Saint Joseph University  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Bengu","family":"Cobanoglu","sequence":"additional","affiliation":[{"name":"Karadeniz Technical University Department of Otolaryngology\u2010Head and Neck Surgery  Trabzon Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrocelli","family":"Marzia","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Operative Unit Bellaria and Maggiore Hospitals  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maider","family":"Andueza\u2010Guembe","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology\u2014Head and Neck Surgery Department Donostia University Hospital  St. Sebastian Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Lentini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University Enna Kore  Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Toledo\u2010Villegas","sequence":"additional","affiliation":[{"name":"Universidad Finis Terrae\u2014Head and Neck Surgery Department Complejo Asistencial Barros Luco Trudeau  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Tirelli","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences, Section of Otolaryngology University of Trieste  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Tramontano","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences University Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6830-9309","authenticated-orcid":false,"given":"Giulio","family":"Cirignaco","sequence":"additional","affiliation":[{"name":"Division of Maxillofacial Surgery, Department of Neurological Sciences Marche University Hospitals\u2010Umberto I  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Head and Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies (YO\u2010IFOS)  Paris France"},{"name":"Department of Head and Neck Surgery CHU Saint\u2010Pierre, Universit\u00e9 libre de Bruxelles (ULB)  Brussels Belgium"},{"name":"Laboratory of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy Research Institute for Health Sciences and Technology, University of Mons (UMONS)  Mons Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sefa","family":"\u0130ncaz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Marmara University Pendik Training and Research Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"De Riu","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy University of Sassari  Sassari Italy"},{"name":"Department of Medicine, Section of Maxillo\u2010Facial Surgery University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Jatin Shah's Head and Neck Surgery and Oncology","author":"Shah J.","year":"2007"},{"key":"e_1_2_11_3_1","first-page":"209","volume-title":"World Health OrganiZation Classification of Tumours. 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