Treatment of Parotid Malignancies—10 Years of Experience

J Oral Maxillofac Surg. 2015 Jul;73(7):1397-402. doi: 10.1016/j.joms.2014.12.036. Epub 2015 Jan 12.

Abstract

Purpose: Operative treatment is the main treatment option for parotid gland tumors. The purpose of this study was to present the authors' experience in the operative treatment of parotid gland malignant tumors, especially regarding feasibility and techniques in the most advanced cases.

Materials and methods: This is a retrospective cohort study of parotid malignancies. The study included patients treated at the authors' university clinic from 2000 through 2010. The primary predictor variable was stage of disease. The primary outcome variables were 3- and 5-year overall and disease-free survival rates. The secondary predictor variables were nodal status, distant metastases, status of the facial nerve (FN), tumor diameter, extraparotid tumor extension, histology, and surgical procedure. The outcome variable was survival rate. Data were analyzed by χ(2) tests.

Results: Of 867 parotid tumors, 103 patients with malignancies (47 female, 56 male; 12 to 88 yr old) underwent 24 partial lateral, 34 lateral, 39 total, and 6 extended parotidectomies. The 3- and 5-year overall survival and 3- and 5-year disease-free survival rates for stages T1 and T2 were 100, 99, 91, and 85%, respectively, and those for stages T3 and T4 were 100, 70, 48, and 34%, respectively. Overall and disease-free survival rates were influenced by FN paralysis and histologic type.

Conclusions: Final oncologic outcomes, recurrence, and survival rates in parotid malignancies are considerably affected by local tumor stage, malignancy, and FN paralysis before treatment. Infiltration of adjacent structures is not connected with a poorer prognosis as long as an extended parotidectomy is performed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Adenoid Cystic / surgery
  • Carcinoma, Squamous Cell / surgery
  • Child
  • Cohort Studies
  • Disease-Free Survival
  • Facial Nerve Diseases / diagnosis
  • Facial Paralysis / diagnosis
  • Female
  • Humans
  • Lymphatic Metastasis / diagnosis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Parotid Gland / surgery
  • Parotid Neoplasms / surgery*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Young Adult