Risk factors for subsequent recurrence after surgical treatment of recurrent pleomorphic adenoma of the parotid gland

Rooker, Steven A.; Abel, Kathryn M. Van; Yin, Linda X.; Nagelschneider, Alex A.; Price, Daniel L.; Olsen, Kerry D.; Janus, Jeffrey R.; Kasperbauer, Jan L.; Moore, Eric J.

doi:10.1002/hed.26570

Cited by 14 publications

(19 citation statements)

References 31 publications

(127 reference statements)

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“…The recurrence rate of PA is 6.7–45%, and the malignant transformation rate is 1.5% in the first 5 years and increases thereafter. 3 , 4 Therefore, radical surgery is recommended in clinical practice. 5 , 6 However, WTs do not recur and less than 0.1–0.3% of these tumors become malignant.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Wei

Shao

Tian

et al. 2021

CMAR

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To investigate the value of the signal intensity on T2-weighted magnetic resonance (MR) imaging using quantitative analysis in the differentiation of parotid tumors. Materials and Methods: MR data of 80 pleomorphic adenomas (PAs), 68 Warthin tumors (WTs), and 34 malignant tumors (MTs) confirmed by surgery and histology were retrospectively analyzed. The signal intensities of tumor, normal parotid gland, spinal cord, and buccal subcutaneous fat were measured, and the signal intensity ratios (SIRs) between the tumor and the three references were calculated. Receiver operating characteristic curve was used to determine the optimal threshold and diagnostic efficiency of SIR for differentiating PAs, WTs, and MTs. Results: The area under the curve (AUC) of tumor to parotid gland SIR (SIR P ), tumor to spinal cord SIR (SIR C ), and tumor to buccal subcutaneous fat SIR (SIR F ) for differentiating PAs and WTs was 0.922, 0.918, and 0.934, respectively. The sensitivity and specificity at an optimal SIR threshold were 86.3% and 91.2%, 80.0% and 97.1%, and 85.0% and 94.1%, respectively. The AUC of SIR P , SIR C , and SIR F for distinguishing PAs from MTs was 0.793, 0.802, and 0.774, respectively. The sensitivity and specificity at an optimal SIR threshold was 86.3% and 61.8%, 80.0% and 73.5%, and 82.5% and 73.5%, respectively. The AUC of SIR P , SIR C , and SIR F for distinguishing WTs from MTs was 0.716, 0.709, and 0.759, respectively. The sensitivity and specificity at an optimal SIR threshold were 61.8% and 82.4%, 55.9% and 82.4%, and 64.7% and 86.8%, respectively. Conclusion: SIR P , SIR C , and SIR F on T2-weighted MR images had high diagnostic efficiency for differentiating between PAs and WTs, while SIR P and SIR C for differentiating between PAs and MTs, and SIR F for differentiating between WTs and MTs had relatively high diagnostic efficiency.

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Section: Introductionmentioning

confidence: 99%

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Wei

Shao

Tian

et al. 2021

CMAR

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“…Recurrent PAs may pose a significant clinical problem [ 81 , 82 , 83 ]. With current management of parotid PAs, the recurrence rate is around 3% [ 3 , 83 ].…”

Section: Clinical Significance Of Genomic Alterations In Pamentioning

confidence: 99%

Chromosome Translocations, Gene Fusions, and Their Molecular Consequences in Pleomorphic Salivary Gland Adenomas

et al. 2022

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Salivary gland tumors are a heterogeneous group of tumors originating from the major and minor salivary glands. The pleomorphic adenoma (PA), which is the most common subtype, is a benign lesion showing a remarkable morphologic diversity and that, upon recurrence or malignant transformation, can cause significant clinical problems. Cytogenetic studies of >500 PAs have revealed a complex and recurrent pattern of chromosome rearrangements. In this review, we discuss the specificity and frequency of these rearrangements and their molecular/clinical consequences. The genomic hallmark of PA is translocations with breakpoints in 8q12 and 12q13-15 resulting in gene fusions involving the transcription factor genes PLAG1 and HMGA2. Until recently, the association between these two oncogenic drivers was obscure. Studies of the Silver–Russel syndrome, a growth retardation condition infrequently caused by mutations in IGF2/HMGA2/PLAG1, have provided new clues to the understanding of the molecular pathogenesis of PA. These studies have demonstrated that HMGA2 is an upstream regulator of PLAG1 and that HMGA2 regulates the expression of IGF2 via PLAG1. This provides a novel explanation for the 8q12/12q13-15 aberrations in PA and identifies IGF2 as a major oncogenic driver and therapeutic target in PA. These studies have important diagnostic and therapeutic implications for patients with PA.

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“…According to the literature review, there are three reasons to explain the development of RPA: patient-associated, tumorassociated, and surgery-associated factors. [5][6][7][8] PA recurrence is more common in females and younger patients. Satellite nodules, an incomplete capsule, and a mucoidrich type of PA are tumor-associated factors associated with RPA.…”

Section: Introductionmentioning

confidence: 99%

“…The exact cause of RPA remains unknown. According to the literature review, there are three reasons to explain the development of RPA: patient‐associated, tumor‐associated, and surgery‐associated factors 5–8 . PA recurrence is more common in females and younger patients.…”

Section: Introductionmentioning

confidence: 99%

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Recurrent pleomorphic adenoma of the parotid gland: A population‐based study with emphasis on re‐recurrence and malignant transformation

Zhang

et al. 2022

Head & Neck

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Background This study aimed to analyze the prognostic determinants for re‐recurrence and malignant transformation of parotid recurrent pleomorphic adenoma (RPA). Methods Between January 2011 and December 2020, all the cases of RPA of the parotid gland at our single institution were reviewed. Results A total of 168 patients were included in this study, with a median age of 41.5 years, and 20 (11.9%) patients developed re‐recurrence during follow‐up. It has been evidenced that recurrence times (single or multiple) was an independent prognostic factor for recurrence‐free survival (p = 0.0264). A total of 26 (15.48%) patients experienced malignant transformation of parotid RPA, and older age (>45 year old), male sex, and higher clinical tumor staging (T3–T4) were significantly associated with malignant transformation of parotid RPA. Conclusions Recurrence times was an independent prognostic factor for re‐recurrence of parotid RPA, and older male with high T‐stage may more easily develop malignant transformation.

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Risk factors for subsequent recurrence after surgical treatment of recurrent pleomorphic adenoma of the parotid gland

Cited by 14 publications

References 31 publications

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Quantitative Analysis and Pathological Basis of Signal Intensity on T2-Weighted MR Images in Benign and Malignant Parotid Tumors

Chromosome Translocations, Gene Fusions, and Their Molecular Consequences in Pleomorphic Salivary Gland Adenomas

Recurrent pleomorphic adenoma of the parotid gland: A population‐based study with emphasis on re‐recurrence and malignant transformation

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