A novel clinically-oriented classification of fine-needle aspiration cytology for salivary gland tumors: a 20-year retrospective analysis of 1175 patients

Taniuchi, Masataka; Kawata, Ryo; Omura, Shuji; Haginomori, Shin‐Ichi; Takato, Tsuyoshi; Higashino, Masaaki; Kurisu, Yoshitaka; Hirose, Yoshinobu

doi:10.1007/s10147-020-01816-5

Cited by 10 publications

(5 citation statements)

References 18 publications

(20 reference statements)

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“…The results of fine‐needle aspiration cytology (FNAC) obtained preoperatively in 66 patients were analyzed. FNAC was performed with a 22G needle under US guidance, and the results were evaluated according to the Osaka Medical College (OMC) classification 8 used at our institution. The FNAC‐based diagnosis was made by three pathologists (co‐authors).…”

Section: Methodsmentioning

confidence: 99%

Management and outcome of parotid mucoepidermoid carcinoma by histological grade: A 21‐year review

Taniuchi

Kawata

Takato

et al. 2022

Laryngoscope Investig Oto

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Objective Mucoepidermoid carcinoma (MEC) is the most common malignancy of the parotid gland, but the outcome depends on the histological grade. Therefore, the aim of this study was to evaluate MEC on the basis of histological grade. Study Design Retrospective analysis. Methods We performed a retrospective analysis of data from patients whose initial treatment for MEC of the parotid gland was performed at our department between 1999 and 2021. We examined the association between the Armed Forces Institute of Pathology (AFIP) grade and outcome. Results The AFIP grades were as follows: low, 26 cases; intermediate, 9 cases; and high, 31 cases. About 50% of cases were correctly diagnosed as malignant, and both grade and histology were accurately determined by fine‐needle aspiration cytology in 20% of cases. The 5‐year disease‐free survival rate was 95.5% and 53.8% in the low‐/intermediate‐ and high‐grade cases, respectively. In the high‐grade group, cases with recurrence were found to have a higher rate of lymph nodes metastasis than cases without recurrence. Furthermore, in this high‐grade group, total sacrifice of the facial nerve did not reduce local recurrence. However, radical resection in the cases without tumor invasion to the nerve has decreased the local recurrence rate. The CRTC1‐MAML2 fusion gene was expressed in 42.3% of low‐/intermediate‐ and 14.3% of high‐grade cases. Conclusions The survival rate in MEC was quite different between the low‐/intermediate‐ and high‐grade cases. However, the rate of correct assessment of the grade by fine‐needle aspiration cytology was poor. In high‐grade cases, total sacrifice of the facial nerve may improve the rate of local recurrence in cases without invasion of the main trunk of the nerve. Expression of the CRTC1‐MAML2 fusion gene could be helpful in not only the assessment of grade but the prediction of recurrence. Level of Evidence 4

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Section: Methodsmentioning

confidence: 99%

Management and outcome of parotid mucoepidermoid carcinoma by histological grade: A 21‐year review

Taniuchi

Kawata

Takato

et al. 2022

Laryngoscope Investig Oto

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“…However, because preoperative evaluation of histopathological type and malignancy is essential for treatment selection, we proposed the OMC classification in 2021 from a clinical point of view. 10 Enucleation is contraindicated for pleomorphic adenoma that is evaluated as benign based on histopathological type, and observation without treatment may also be a suitable choice for Warthin tumors. 7,18 This means that histopathological evaluation before surgery is an important factor that can affect the selection of an appropriate treatment policy or surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were examined preoperatively by echoguided FNAC. The results for each histopathological type were classified according to a salivary gland cytology classification system (OMC classification), 10 which consists of 11 categories.…”

Section: Fine-needle Aspiration Cytologymentioning

confidence: 99%

“…Therefore, we have developed a new cytology classification system that incorporates both histology and grade of malignancy (the Osaka Medical College [OMC] classification). 10 Because the occurrence of postoperative facial nerve palsy depends highly on the skill of the surgeon and the surgical procedures used, the rate of postoperative facial nerve palsy and its risk factors should be investigated in a single center. Information on the frequency and risk factors of facial nerve palsy would be useful when explaining the surgical procedure to patients before surgery.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors of Postoperative Facial Palsy for Benign Parotid Tumors: Outcome of 1,018 Patients

et al. 2021

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The aim of this study was to evaluate the rate of postoperative facial palsy in benign parotid tumors, as well as its risk factors, pathology, and clinical results.Study Design: Retrospective analysis.Methods: We performed a retrospective analysis of data from patients whose initial operation for a benign parotid tumor had been performed in our department between 1999 and 2020.Results: We included 1,018 patients in this study. The most common tumor observed was pleomorphic adenoma (614 patients), followed by Warthin tumor (234 patients). Fine-needle aspiration cytology and frozen section biopsy were used to identify the tumor histopathology. The overall rate of postoperative facial nerve palsy was 19.5%; the rate was significantly higher in patients with large-diameter tumors or deep lobe tumors. Postoperative facial palsy improved within 24 months of surgery in all cases. There were no cases with permanent facial palsy.Conclusions: Postoperative facial nerve palsy developed regularly after surgery to remove benign parotid tumors despite preservation of the nerve. Palsy rate was high in patients with large tumors or deep lobe tumors. Despite the high risk of facial palsy in these patients and the benign nature of the tumor, we recommend surgery rather than follow-up observation, as the risk of postoperative facial palsy may increase as the tumor grows. It is important to provide an accurate explanation on the risks of postoperative complications to all patients to obtain appropriate informed consent for surgery.

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“…Distinguishing a benign tumor from a malignant one can be complex due to variability in sample size and technique ( Taniuchi et al, 2021 ). In cases of limited cellularity or sample artifact, immunohistochemistry (IHC) can provide significant insight.…”

Section: Case Studymentioning

confidence: 99%

Using Pleomorphic Adenoma Gene 1 (PLAG1) to Distinguish Carcinoma of the Parotid Gland From Primary Lung Cancer: A Case Study

East

2023

JADPRO

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A novel clinically-oriented classification of fine-needle aspiration cytology for salivary gland tumors: a 20-year retrospective analysis of 1175 patients

Cited by 10 publications

References 18 publications

Management and outcome of parotid mucoepidermoid carcinoma by histological grade: A 21‐year review

Management and outcome of parotid mucoepidermoid carcinoma by histological grade: A 21‐year review

Risk Factors of Postoperative Facial Palsy for Benign Parotid Tumors: Outcome of 1,018 Patients

Using Pleomorphic Adenoma Gene 1 (PLAG1) to Distinguish Carcinoma of the Parotid Gland From Primary Lung Cancer: A Case Study

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