Fine‐needle aspiration with selective use of core needle biopsy of major salivary gland tumors

Romano, Erica; Wagner, Jason M.; Alleman, Anthony; Zhao, Lichao; Conrad, Robert; Krempl, Greg A.

doi:10.1002/lary.26643

Cited by 28 publications

(27 citation statements)

References 18 publications

(35 reference statements)

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“…CNB might be an alternative in hospitals where FNAC cannot be established or contrasts with the clinical presentation. Another strategy is to use CNB as an option for selected cases when the cytopathologist suggests after initial review of a FNAC that a definitive diagnosis requires a more extensive tissue sample ( 26 ).…”

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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“…Core needle biopsy (CNB) has a high sensitivity of 92%, but requires the use of a larger bore needle, which increases the risks of tumor seeding, hematoma, and facial nerve injury . Incisional biopsies are generally avoided in major salivary gland masses due to risks of tumor seeding, nerve damage, scarring, and possible fistula development .…”

Section: Discussionmentioning

confidence: 99%

Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins

et al. 2019

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Objectives Determine rate of preoperative biopsy in parotid malignancies, identify factors associated with its use, and its association with surgical margins. Study Design Retrospective cohort. Setting Commission on Cancer–Accredited Institutions. Subjects and Methods We included 5533 patients treated surgically for a parotid malignancy 2004–2014 in the National Cancer Database. Chi‐squared tests, univariable, and multivariable logistic regressions were used to evaluate predictors of preoperative biopsy (defined as needle, aspiration, or incisional), and associate biopsy with surgical margins. Results Preoperative biopsy was utilized in 26.0% of patients. Biopsy was more likely in patients >60 years (odds ratio [OR]: 1.19, P = .035), advanced clinical T stage (vs. T1,T2 OR: 1.23, P = .009; T3 OR: 1.26, P = .026; T4A OR: 2.05, P < .001), advanced clinical N stage (vs. N0, N1: OR: 1.39, P = .013; N2/3: OR: 1.63, P < .001), in academic centers (OR: 1.18, P < .024), and in higher volume centers (vs. low, medium OR: 1.28, P = .002; high OR: 2.16, P < .001). Biopsy use increased over time (vs. 2004–2006, 2007–2010 OR: 1.20, P = .047; 2011–2014 OR: 1.39, P < .001). Biopsy was associated with a reduced risk of positive margins in patients with clinical T1 stage (OR: 0.70, P = .012), and younger than 61 (OR: 0.79, P = .036). Conclusion The national rate of preoperative biopsy in parotid malignancy is low at 26.0%, but has increased over time. Preoperative biopsy is associated with a reduced risk of positive margins in younger patients and those with early clinical stage, suggesting its increased use may improve surgical outcomes and decrease reoperation or adjuvant therapy in these subgroups of patients. Level of Evidence 3 Laryngoscope, 130:1450–1458, 2020

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“…3,[6][7][8] Cytopathologists may be on-site to determine specimen adequacy at the time of biopsy, and the resulting specimens are generally examined at a single tertiary care institution. 3,[6][7][8] Indeed, some studies examining the utility of FNB for salivary gland lesions note that variations in technique, operator, and pathologists (community vs academic practice) may be confounding factors in establishing its usefulness. 5 The majority of patients with salivary gland lesions first present to community otolaryngology practices.…”

mentioning

confidence: 99%

“… 3 , 6 - 8 Ultrasound-guided FNB is commonly performed by radiologists or pathologists rather than otolaryngologists. 3 , 6 - 8 Cytopathologists may be on-site to determine specimen adequacy at the time of biopsy, and the resulting specimens are generally examined at a single tertiary care institution. 3 , 6 - 8 Indeed, some studies examining the utility of FNB for salivary gland lesions note that variations in technique, operator, and pathologists (community vs academic practice) may be confounding factors in establishing its usefulness.…”

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confidence: 99%

Diagnostic Accuracy of Fine‐Needle Biopsy for Salivary Gland Neoplasms in a Community Otolaryngology Practice

2020

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Objective To assess the diagnostic accuracy of fine-needle biopsy (FNB) of salivary gland neoplasms via ultrasound (US) or palpation guidance by an otolaryngologist in a community practice. Study Design Retrospective chart review. Setting Community otolaryngology practice. Methods Retrospective analysis was conducted for all office-based salivary gland FNBs from a community practice from 2005 through 2018. There were 433 FNBs performed among 370 patients. The likelihood of achieving a diagnostic result based on method (US vs palpation guidance) was calculated. Of this cohort, 196 cases had surgical follow-up (parotid gland, n = 168; submandibular gland, n = 28). Correlation of preoperative FNB results to final surgical pathology was performed and measures of diagnostic accuracy computed. Results US-guided FNBs were more likely to achieve a diagnostic result than FNBs obtained via palpation guidance ( P = .00002). Parotid gland FNBs demonstrated a sensitivity and specificity of 78.57% and 92.44%, respectively. Submandibular FNBs demonstrated a sensitivity and specificity of 57.14% and 93.74%. Conclusion FNBs performed under US guidance are more likely to achieve a diagnostic specimen than those performed under palpation guidance. FNBs of parotid gland tumors may be assessed with diagnostic accuracy in the community setting that is similar to that achieved at tertiary care centers. Further research is needed to ascertain whether this finding extends to FNBs of submandibular gland tumors. Offering this procedure at point of care in the community may improve compliance and reduce wait time.

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Fine‐needle aspiration with selective use of core needle biopsy of major salivary gland tumors

Abstract: 4. Laryngoscope, 127:2522-2527, 2017.

Cited by 28 publications

References 18 publications

Contemporary Management of Benign and Malignant Parotid Tumors

Contemporary Management of Benign and Malignant Parotid Tumors

Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins

Diagnostic Accuracy of Fine‐Needle Biopsy for Salivary Gland Neoplasms in a Community Otolaryngology Practice

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