{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:14:15Z","timestamp":1772986455443,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Lymph node (LN) status is an important prognostic factor for parotid gland cancer (PGC). This study aimed to analyze the impact of extranodal extension (ENE) of intraparotid LN and LN metastasis burden on survival in PGC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with surgically treated PGC and at least one metastatic cervical LN were retrospectively enrolled. Primary outcome variables were distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS). The impact of ENE and LN metastasis burden was assessed using the Cox model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 292 patients were included. ENE in cervical or intraparotid LN was not associated with DMFS, DSS, or OS. Intraparotid LN metastasis had a significant impact on prognosis, and the presence of only one metastatic intraparotid LN offered an approximately 1.5-fold risk of distant metastasis. Prognostic models based on the number of positive LNs (1 vs. 2\u20133 vs. 4+) were superior to the AJCC N stage in terms of DMFS, DSS, and OS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>ENE of cervical or intraparotid LN has a limited effect on the prognosis of PGC, and the number of positive LNs is better than the AJCC N stage in LN status evaluation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-024-04346-y","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T12:02:53Z","timestamp":1716292973000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The 8th AJCC classification is inferior to a new neck stage based on intraparotid lymph node in parotid gland cancer"],"prefix":"10.1186","volume":"24","author":[{"given":"Xiaoxue","family":"Han","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuexin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuexiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"4346_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.coms.2018.08.007","volume":"31","author":"ER Carlson","year":"2019","unstructured":"Carlson ER, Schlieve T. Salivary gland malignancies. Oral Maxillofac Surg Clin North Am. 2019;31:125\u201344.","journal-title":"Oral Maxillofac Surg Clin North Am"},{"key":"4346_CR2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s11864-017-0484-y","volume":"18","author":"SH Huang","year":"2017","unstructured":"Huang SH, O\u2019Sullivan B. Overview of the 8th edition TNM classification for head and neck cancer. Curr Treat Options Oncol. 2017;18:40.","journal-title":"Curr Treat Options Oncol"},{"key":"4346_CR3","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/978-3-642-38850-7_3","volume":"160","author":"J Dutra","year":"2014","unstructured":"Dutra J, Paintal A. Head and neck. Cancer Treat Res. 2014;160:31\u201357.","journal-title":"Cancer Treat Res"},{"key":"4346_CR4","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1002\/hed.25603","volume":"41","author":"CE Hsieh","year":"2019","unstructured":"Hsieh CE, Hung CY, Lin CY, Chen JS, Chang KP, Aithala SP, Lee LY, Tsang NM, Lu CH, Chen MF, Cheng YF, Yeh KY, Wang CH, Chou WC. High metastatic node number, not extranodal extension, as a node-related prognosticator in surgically treated patients with nodal metastatic salivary gland carcinoma. Head Neck. 2019;41:1572\u201382.","journal-title":"Head Neck"},{"key":"4346_CR5","doi-asserted-by":"publisher","first-page":"105076","DOI":"10.1016\/j.oraloncology.2020.105076","volume":"112","author":"D Lombardi","year":"2021","unstructured":"Lombardi D, Tomasoni M, Paderno A, Mattavelli D, Ferrari M, Battocchio S, Missale F, Mazzola F, Peretti G, Mocellin D, Borsetto D, Fussey JM, Nankivell P, Skalidi N, Bussi M, Giordano L, Galli A, Arrigoni G, Raffetti E, Pracy P, Vander Poorten V, Nicolai P. The impact of nodal status in major salivary gland carcinoma: a multicenter experience and proposal of a novel N classification. Oral Oncol. 2021;112:105076.","journal-title":"Oral Oncol"},{"key":"4346_CR6","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1002\/hed.26135","volume":"42","author":"H Lee","year":"2020","unstructured":"Lee H, Roh JL, Cho KJ, Choi SH, Nam SY, Kim SY. Positive lymph node number and extranodal extension for predicting recurrence and survival in patients with salivary gland cancer. Head Neck. 2020;42:1994\u20132001.","journal-title":"Head Neck"},{"key":"4346_CR7","doi-asserted-by":"publisher","first-page":"11185","DOI":"10.1038\/s41598-023-38227-1","volume":"13","author":"X Han","year":"2023","unstructured":"Han X, Wang J, Li Y, Xi S, Xiao W. Intraparotid lymph node metastasis affects distant metastasis in parotid adenoid cystic carcinoma. Sci Rep. 2023;13:11185.","journal-title":"Sci Rep"},{"key":"4346_CR8","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1016\/j.ejso.2023.04.002","volume":"49","author":"Q Fang","year":"2023","unstructured":"Fang Q, Zhang X, Dai L, Luo R, Yuan J. Association between factor of parotid lymph node and prognosis in parotid cancer. Eur J Surg Oncol. 2023;49:1405\u201310.","journal-title":"Eur J Surg Oncol"},{"key":"4346_CR9","doi-asserted-by":"publisher","first-page":"3171","DOI":"10.1002\/cncr.31535","volume":"124","author":"K Aro","year":"2018","unstructured":"Aro K, Ho AS, Luu M, Kim S, Tighiouart M, Clair JM, Yoshida EJ, Shiao SL, Leivo I, Zumsteg ZS. Development of a novel salivary gland cancer lymph node staging system. Cancer. 2018;124:3171\u201380.","journal-title":"Cancer"},{"key":"4346_CR10","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1002\/lary.27701","volume":"129","author":"Y Feng","year":"2019","unstructured":"Feng Y, Liu F, Cheng G, Fang Q, Niu X, He W. Significance of intraparotid node metastasis in predicting local control in primary parotid cancer. Laryngoscope. 2019;129:2309\u201312.","journal-title":"Laryngoscope"},{"key":"4346_CR11","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s12105-022-01420-1","volume":"16","author":"A Sk\u00e1lov\u00e1","year":"2022","unstructured":"Sk\u00e1lov\u00e1 A, Hyrcza MD, Leivo I. Update from the 5th edition of the World Health Organization classification of head and neck tumors: salivary glands. Head Neck Pathol. 2022;16:40\u201353.","journal-title":"Head Neck Pathol"},{"key":"4346_CR12","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27676","author":"Q Fang","year":"2024","unstructured":"Fang Q, Yuan J, Zhang X, Dai L, Luo R, Xu C. Neck management in cutaneous squamous cell carcinoma with parotid metastasis. Head Neck. 2024. https:\/\/doi.org\/10.1002\/hed.27676","journal-title":"Head Neck"},{"key":"4346_CR13","doi-asserted-by":"publisher","first-page":"105499","DOI":"10.1016\/j.oraloncology.2021.105499","volume":"122","author":"V Patel","year":"2021","unstructured":"Patel V, Galloway TJ, Liu JC. The impact of positive margin on survival in oral cavity squamous cell carcinoma. Oral Oncol. 2021;122:105499.","journal-title":"Oral Oncol"},{"key":"4346_CR14","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.bjoms.2020.09.015","volume":"59","author":"G Tirelli","year":"2021","unstructured":"Tirelli G, Tofanelli M, Sacchet E, Bussani R, Shafiei V, Gatto A, Boscolo-Rizzo P, Gardenal N. Extranodal extension in head and neck squamous cell cancer: is there a role for further stratification? Br J Oral Maxillofac Surg. 2021;59:567\u201372.","journal-title":"Br J Oral Maxillofac Surg"},{"key":"4346_CR15","doi-asserted-by":"crossref","unstructured":"Seng D, Fang Q, Liu F, Luo R, Liu S. Intraparotid lymph node metastasis decreases survival in pediatric patients with parotid cancer. J Oral Maxillofac Surg. 2020;78:852.e1\u2013852.e6.","DOI":"10.1016\/j.joms.2020.01.008"},{"key":"4346_CR16","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1186\/s12885-019-5637-x","volume":"19","author":"X Niu","year":"2019","unstructured":"Niu X, Fang Q, Liu F. Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland. BMC Cancer. 2019;19:417.","journal-title":"BMC Cancer"},{"key":"4346_CR17","doi-asserted-by":"publisher","first-page":"122","DOI":"10.3322\/caac.21389","volume":"67","author":"WM Lydiatt","year":"2017","unstructured":"Lydiatt WM, Patel SG, O\u2019Sullivan B, Brandwein MS, Ridge JA, Migliacci JC, Loomis AM, Shah JP. Head and neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67:122\u201337.","journal-title":"CA Cancer J Clin"},{"key":"4346_CR18","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1186\/s12885-019-5711-4","volume":"19","author":"Q Fang","year":"2019","unstructured":"Fang Q, Wu J, Du W, Zhang X. Predictors of distant metastasis in parotid acinic cell carcinoma. BMC Cancer. 2019;19:475.","journal-title":"BMC Cancer"},{"key":"4346_CR19","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.oraloncology.2014.12.006","volume":"51","author":"TT Peters","year":"2015","unstructured":"Peters TT, Senft A, Hoekstra OS, Castelijns JA, Witte BI, Leemans CR, de Bree R. Pretreatment screening on distant metastases and head and neck cancer patients: validation of risk factors and influence on survival. Oral Oncol. 2015;51:267\u201371.","journal-title":"Oral Oncol"},{"key":"4346_CR20","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1002\/jso.23874","volume":"111","author":"HR Hong","year":"2015","unstructured":"Hong HR, Roh JL, Cho KJ, Choi SH, Nam SY, Kim SY. Prognostic value of lymph node density in high-grade salivary gland cancer. J Surg Oncol. 2015;111:784\u20139.","journal-title":"J Surg Oncol"},{"key":"4346_CR21","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1186\/s12885-021-08877-3","volume":"21","author":"H Suzuki","year":"2021","unstructured":"Suzuki H, Sasaki E, Takano G, Goto S, Nishikawa D, Beppu S, Terada H, Sawabe M, Hanai N. Lymph node ratio as a predictor for minor salivary gland cancer in head and neck. BMC Cancer. 2021;21:1186.","journal-title":"BMC Cancer"},{"key":"4346_CR22","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1002\/hed.27222","volume":"45","author":"AJ Gordon","year":"2023","unstructured":"Gordon AJ, Chow MS, Patel A, Hu KS, Li Z, Jacobson AS, Vaezi AE, Tam MM, Givi B. Adoption of adjuvant chemotherapy in high-risk salivary gland malignancies. Head Neck. 2023;45:167\u201377.","journal-title":"Head Neck"},{"key":"4346_CR23","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.715","author":"AM Patel","year":"2024","unstructured":"Patel AM, Haleem A, Choudhry HS, Povolotskiy R, Roden DF. Patterns and trends in adjuvant therapy for major salivary gland cancer. Otolaryngol Head Neck Surg. 2024. https:\/\/doi.org\/10.1002\/ohn.715","journal-title":"Otolaryngol Head Neck Surg"},{"key":"4346_CR24","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1001\/jamaoto.2016.2168","volume":"142","author":"A Amini","year":"2016","unstructured":"Amini A, Waxweiler TV, Brower JV, Jones BL, McDermott JD, Raben D, Ghosh D, Bowles DW, Karam SD. Association of adjuvant chemoradiotherapy vs radiotherapy alone with survival in patients with resected major salivary gland carcinoma: data from the national cancer data base. JAMA Otolaryngol Head Neck Surg. 2016;142:1100\u201310.","journal-title":"JAMA Otolaryngol Head Neck Surg"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04346-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-024-04346-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04346-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T12:02:57Z","timestamp":1716292977000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-024-04346-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,21]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4346"],"URL":"https:\/\/doi.org\/10.1186\/s12903-024-04346-y","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,21]]},"assertion":[{"value":"7 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by China Medical University Institutional Research Committee, and informed consent was obtained from all subjects before initial research. All methods were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"590"}}