Survival in Patients with Primary Parotid Gland Carcinoma after Surgery—Results of a Single-Centre Study

Abstract

This study aims to analyse a single-centre cohort series of patients who underwent parotidectomy for primary malignant parotid tumours. A retrospective chart review of 64 consecutive patients treated from November 2010 to March 2022 was performed. Outcomes were analysed by Kaplan-Meier curves. Sixty-four patients with a primary parotid malignancy were included in the study, with one bilateral case in this cohort. Patients were classified as stage I–II in 39 cases and stage III–IV in 26 cases. The five-year overall survival (OS), disease-specific survival (DSS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 78.4%, 89%, 92.5%, and 87.1%, respectively. Univariate analysis showed that high-risk histology, stage IV disease, lymphovascular invasion, perineural invasion, node metastasis, skin involvement, facial nerve involvement, and positive or close margins were risk factors associated with poorer outcomes. At present, the best evidence suggests that radical surgery should be the standard approach, and adjuvant therapy, in terms of radiotherapy/chemoradiotherapy, is recommended in patients with risk factors.

Machine learning-based survival prediction nomogram for postoperative parotid mucoepidermoid carcinoma

“…The role of radiotherapy in treating mucoepidermoid carcinoma of the salivary glands has not been thoroughly examined in prior research. Our in-depth analysis of patients who underwent postoperative radiotherapy suggests that individuals in low-risk categories may not derive significant benefits from this treatment 20 – 23 . Additionally, our findings regarding LNR diverge from those of previous studies, which will be elaborated upon in subsequent sections of this paper.…”

“…Currently, the treatment of primary mucoepidermoid carcinoma of the parotid gland is based on the overall treatment strategy of parotid gland cancer, according to the National Comprehensive Cancer Network (NCCN) guidelines 27 . The role of radiotherapy as a protective prognostic factor for parotid cancer patients has been a subject of controversy 20 – 23 . For patients with advanced, high-grade (poorly differentiated or undifferentiated), nerve or vascular invasion, insufficient or positive margins, extraparotid invasion, or lymph node involvement, postoperative radiotherapy is recommended.…”

Surgical Management of Patients with Parotid Involvement from Non-Melanoma Skin Cancer of the Head and Neck

“…A diagnostic work-up of advanced hnNMSC is based on imaging, histology, and cytology [ 34 ]. MRI is generally considered more accurate in the diagnostic assessment of parotid lesions [ 35 ].…”

“…Parotidectomies should be extended to the deep lobe of the gland only when it is macroscopically involved, because lymph nodes are rarely observed in the deep lobe [ 34 , 41 , 42 , 43 ].…”

“…Another major challenge in patients with hnNMSC with involvement of the parotid region is the management of the FN, because its sacrifice has a negative impact on quality of life. Direct nerve infiltration with preoperative palsy is a clear indication for nerve sacrifice [ 34 ], while in patients without preoperative nerve impairment, it can be difficult to predict when a partial or complete sacrifice of the nerve is necessary to achieve an oncologically sound resection [ 48 ]. Conservative nerve-sparing approaches have been reported in the literature in the cases of intraoperative evidence of FN involvement with preoperative normal function, leaving microscopic residual disease involving the nerve, followed by timely postoperative RT [ 49 , 50 ].…”