Surgical management of head and neck squamous cell carcinoma metastatic to the parotid gland

TL;DR

This paper reviews surgical approaches for treating head and neck cancer that has spread to the parotid gland, focusing on improving patient outcomes.

Contribution

The study provides a narrative review and flow chart to guide surgical decision-making for metastatic head and neck squamous cell carcinoma.

Findings

Surgical treatment is likely the most effective means of achieving favorable outcomes in HNSCC metastatic to the parotid gland.

Locoregional recurrence remains the primary cause of mortality in HNSCC, highlighting the importance of surgical intervention.

The extent of parotidectomy and concomitant neck dissection remains a topic of ongoing debate.

Abstract

The parotid gland includes lymph nodes that may contain metastasis from the head and neck region as well as distant metastasis or metastasis from carcinoma/melanoma of an unknown primary (CUP/MUP). This study aimed to review the current literature to evaluate the role of surgical management of head and neck squamous cell carcinoma (HNSCC). A narrative review of the English language literature available in the PubMed and Embase databases from January 2010 to December 2024 was conducted to identify treatment methods and follow-up data for HNSCC metastatic to the parotid gland. This study provides a detailed overview of the histological and diagnostic imaging characteristics as well as the surgical and non-surgical procedures employed in the management of HNSCC metastases to the parotid gland. Furthermore, the management of CUP is outlined. The extent of the parotidectomy and concomitant neck dissection remains a topic of ongoing debate. The flow chart presented in this study may assist in decision-making regarding surgical treatment. Given that locoregional recurrence is the primary cause of mortality in HNSCC, surgical treatment is likely to be the most effective means of achieving a favorable outcome.

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