Extracapsular dissection as sole therapy for small low‐grade malignant tumors of the parotid gland

Mantsopoulos, Konstantinos; Koch, Michael; Iro, Heinrich

doi:10.1002/lary.26482

Cited by 36 publications

(21 citation statements)

References 23 publications

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“…The tumor control rate was 96% and the 5 year survival rate was 100%. The series was updated recently for the patients with low-grade malignancies who received only extracapsular dissection without further surgery or radiotherapy (rejected by the patients) ( 93 ). Within the median follow-up of 66 months (20–126 months) all patients were tumor-free.…”

Section: Resultsmentioning

confidence: 99%

Contemporary Management of Benign and Malignant Parotid Tumors

Thielker

Grosheva

Ihrler³

et al. 2018

Front. Surg.

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To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors.Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors.Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes.The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.

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Section: Resultsmentioning

confidence: 99%

Contemporary Management of Benign and Malignant Parotid Tumors

Thielker

Grosheva

Ihrler³

et al. 2018

Front. Surg.

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“…This could be explained by the fact that the vast majority (>90%) of these lesions were less aggressive, low‐grade subtypes (mucoepidermoid carcinoma, acinic cell carcinoma) with a low potential for occult metastases and a favorable biologic behavior. Another relevant analysis showed very encouraging preliminary results following primary extracapsular dissection as the sole surgical therapy for carefully selected low‐stage, low‐grade, inferiorly located lesions in patients with high compliance . Finally, another report of the same working group did not detect any medium‐term oncologic benefit through completion surgery (completion parotidectomy with ipsilateral neck dissection) in these very cases .…”

Section: Discussionmentioning

confidence: 98%

Paradigm shift in surgery for benign parotid tumors: 19 years of experience with almost 3000 cases

2019

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Objectives The aim of this study was to explore the changes in philosophy in the surgical therapy of benign parotid tumors over a period of 19 years. Methods The records of all patients treated for benign parotid tumors between 2000 and 2018 were evaluated. Data were analyzed with respect to the number of procedures carried out per year of the study according to each of the different surgical modalities and the incidence of postoperative complications. Statistical analysis was performed using the x2 test. A P value of <.05 was considered statistically significant. Results A total of 2988 patients were included in this study. Our analysis showed that the increasing performance of extracapsular dissection was associated with a progressive reduction in the incidence of temporary facial nerve palsy and Frey's syndrome, while the rate of permanent facial nerve palsy remained consistently low. Conclusion One of the most controversial issues in head and neck surgery is which therapeutic approach is best in patients with benign parotid tumors. Our analysis demonstrated that a change of strategy towards reducing invasiveness was possible, with exceptional functional results. Avoidance of facial nerve dissection is feasible in more than two‐thirds of cases with benign tumors. Level of Evidence 4b Laryngoscope, 130: 1941–1946, 2020

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“…Albeit on the less aggressive side of the MEC spectrum, Warthin-like MECs still require a closer follow-up, and clear resection margins are more vital, which emphasize its need to be distinguished from WT. Intriguingly, tumours operated on as benign lesions and postoperatively, unexpectedly, diagnosed as malignant are reported to typically follow a benign course [ 39 – 41 ].Warthin-like MEC is a rare and only recently defined entity [ 9 ], with few cases described in the literature. Its characteristic morphology along with the MAML2 rearrangement is crucial for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

MAML2 rearrangement as a useful diagnostic marker discriminating between Warthin tumour and Warthin-like mucoepidermoid carcinoma

et al. 2020

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Warthin tumour is the second most common benign neoplasm of salivary glands. Despite its relatively characteristic histology, it may sometimes mimic other lesions. Here, we report two female non-smoker patients diagnosed with low-grade mucoepidermoid carcinoma with oncocytic epithelium and prominent lymphoid (Warthin-like) stroma and with molecularly confirmed MAML2 rearrangement. In addition, we screened a consecutive series of 114 Warthin tumour cases by means of MAML2 break apart fluorescence in situ hybridization to assess its value in differential diagnosis. MAML2 rearrangement was detected in both mucoepidermoid carcinoma cases, while all Warthin tumours were negative. Taking into account the literature data, Warthin-like mucoepidermoid carcinomas are more frequently observed in women, while a slight male predominance and smoking history are typical for Warthin tumour. In addition, the patients with Warthin-like mucoepidermoid carcinoma were significantly younger than those with Warthin tumour. To conclude, Warthin-like mucoepidermoid carcinoma may usually be suspected based on histology, while the diagnosis can be confirmed by means of molecular assays such as FISH. The investigation of MAML2 status is particularly advised when Warthin tumour is considered in a young, non-smoking, female patient.

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Extracapsular dissection as sole therapy for small low‐grade malignant tumors of the parotid gland

Abstract: 4. Laryngoscope, 127:1804-1807, 2017.

Cited by 36 publications

References 23 publications

Contemporary Management of Benign and Malignant Parotid Tumors

Contemporary Management of Benign and Malignant Parotid Tumors

Paradigm shift in surgery for benign parotid tumors: 19 years of experience with almost 3000 cases

MAML2 rearrangement as a useful diagnostic marker discriminating between Warthin tumour and Warthin-like mucoepidermoid carcinoma

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