Parotid cancer: analysis of preoperative parameters for adaptation of the therapeutic strategy

Abstract

Purpose: To establish typical clinical and radiological profiles of primary low-grade parotid cancers in order to tailor therapeutic strategy.

Materials and methods: Retrospective study of 57 patients operated on for primary parotid cancer between 2010 and 2021, with review of preoperative MRI and histopathology according to a standardized scoring grid.

Objective: To study prognostic factors and determine the preoperative clinical and radiological profile of low-grade cancers.

Results: Good prognostic factors for specific survival were: staging ≤ cT3 (p = 0.014), absence of adenopathy on cN0 MRI (p < 0.001), superficial lobe location (p = 0.033), pN0 (p < 0.001), absence of capsular rupture (p = 0.004), as well as the absence of peri-tumoral nodules (p = 0.033), intra-parotid adenopathies (p < 0.001), vascular emboli (p < 0.001), peri-neural sheathing (p = 0.016), nuclear atypia (p = 0.031), and necrosis (p = 0.002). It was not possible to define a reliable clinical and radiological profile for low-grade cancers (sensitivity 38%, specificity 79%).

Conclusion: Our study demonstrated multiple factors of good prognosis, but it was not possible to define a clinical and radiological profile of patients likely to benefit from more limited surgery, nor to diagnose, a priori, low-grade cancers.

Keywords: Head and neck cancer; Prognosis factors; Rare cancer; Salivary glands; Surgery.