Comparison of Partial Versus Superficial or Total Parotidectomy for Superficial T1-2 Primary Parotid Cancers
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives. This study aimed to compare the oncological outcomes of partial versus superficial or total parotidectomy forsuperficial T1 or T2 primary parotid cancers and investigate their prognostic factors and recurrence patterns. Methods. The medical records of 77 patients with T1–2 primary parotid malignancies between May 2003 and March 2022were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the prognostic fac-tors associated with overall survival, disease-free survival, and local and distant recurrence. Results. The average follow-up duration was 70.2 months (range, 12–202 months). The 5-year overall and disease-free sur-vival rates were 88.7% and 77.1%, respectively. Twenty-two patients underwent partial parotidectomy, and 55 un-derwent superficial or total parotidectomy. There were no significant differences in the disease recurrence (P =0.320)and mortality rates (P =0.884) of the partial and superficial or total parotidectomy groups. The mean duration of sur-gery was shorter and the overall complication rates were significantly lower in the partial group than in the superfi-cial or total parotidectomy group (P =0.049). Sixteen cases of recurrence occurred during the study period (20.8%). Univariate analyses showed that high-grade tumors (P =0.006), lymphovascular invasion (P =0.046), and regionallymph node metastasis (P =0.010) were significant risk factors for disease recurrence. Multivariate analysis identifiedregional lymph node metastasis as an independent prognostic factor for disease recurrence (P =0.027), and lympho-vascular invasion as an independent prognostic factor for overall survival (P =0.033). Conclusion. The conservative surgical approach of partial parotidectomy can yield oncological outcomes comparable tothose of superficial or total parotidectomy with careful patient selection in T1-2 parotid cancers.
Abstract
Objectives. This study aimed to compare the oncological outcomes of partial versus superficial or total parotidectomy forsuperficial T1 or T2 primary parotid cancers and investigate their prognostic factors and recurrence patterns. Methods. The medical records of 77 patients with T1–2 primary parotid malignancies between May 2003 and March 2022were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the prognostic fac-tors associated with overall survival, disease-free survival, and local and distant recurrence. Results. The average follow-up duration was 70.2 months (range, 12–202 months). The 5-year overall and disease-free sur-vival rates were 88.7% and 77.1%, respectively. Twenty-two patients underwent partial parotidectomy, and 55 un-derwent superficial or total parotidectomy. There were no significant differences in the disease recurrence (P =0.320)and mortality rates (P =0.884) of the partial and superficial or total parotidectomy groups. The mean duration of sur-gery was shorter and the overall complication rates were significantly lower in the partial group than in the superfi-cial or total parotidectomy group (P =0.049). Sixteen cases of recurrence occurred during the study period (20.8%). Univariate analyses showed that high-grade tumors (P =0.006), lymphovascular invasion (P =0.046), and regionallymph node metastasis (P =0.010) were significant risk factors for disease recurrence. Multivariate analysis identifiedregional lymph node metastasis as an independent prognostic factor for disease recurrence (P =0.027), and lympho-vascular invasion as an independent prognostic factor for overall survival (P =0.033). Conclusion. The conservative surgical approach of partial parotidectomy can yield oncological outcomes comparable tothose of superficial or total parotidectomy with careful patient selection in T1-2 parotid cancers.
참고문헌 (22)
- Bussu F, "Clinical history, prognostic factors, and management of facial nerve in malignant tumors of the parotid gland", Clin Exp Otorhinolaryngol, 7(2), pp.126~132 (2014)
- Cracchiolo JR, "Parotidectomy for parotid cancer", Otolaryngol Clin North Am, 49(2), pp.415~424 (2016)
- Huang G, "Superficial parotidectomy versus partial superficial parotidectomy in treating benign parotid tumors", Oncol Lett, 9(2), pp.887~890 (2015)
- Roh JL, "Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy", Br J Surg, 94(9), pp.1081~1087 (2007)
- Slootweg PJ, "World Health Organization 4th edition of head and neck tumor classification : insight into the consequential modifications", Virchows Arch, 472(3), pp.311~313 (2018)
- Amin MB, "AJCC cancer staging manual" (2017), Springer
- Bron LP, "Facial nerve function after parotidectomy", Arch Otolaryngol Head Neck Surg, 123(10), pp.1091~1096 (1997)
- Xiao CC, "Predictors of nodal metastasis in parotid malignancies : a national cancer data base study of 22, 653 patients", Otolaryngol Head Neck Surg, 154(1), pp.121~130 (2016)
- Zenga J, "Mucoepidermoid carcinoma of the parotid : very close margins and adjuvant radiotherapy", ORL J Otorhinolaryngol Relat Spec, 81(1), pp.55~62 (2019)
- Zenga J, "Close margins and adjuvant radiotherapy in acinic cell carcinoma of the parotid gland", JAMA Otolaryngol Head Neck Surg, 144(11), pp.1011~1016 (2018)
- Stodulski D, "Close surgical margin after conservative parotidectomy in early stage low-", intermediate-grade parotid carcinoma : outcome of watch and wait policy, 2017, pp.68, 1~4
- Lombardi D, "Surgical treatment of salivary malignant tumors", Oral Oncol, 65, pp.102~113 (2017)
- Geiger JL, "Management of salivary gland malignancy : ASCO Guideline", J Clin Oncol, 39(17), pp.1909~1941 (2021)
- Klussmann JP, "Patterns of lymph node spread and its influence on outcome in resectable parotid cancer", Eur J Surg Oncol, 34(8), pp.932~937 (2008)
- Lim YC, "Conservative parotidectomy for the treatment of parotid cancers", Oral Oncol, 41(10), pp.1021~1027 (2005)
- Park YM, "Clinical-pathological prognostic factors and treatment failure patterns in T1-2 high-grade parotid gland cancer", Oral Oncol, 110, pp.104884~ (2020)
- Lee KC, "Does total parotidectomy improve survival over partial parotidectomy in early-stage adenoid cystic carcinoma of the parotid gland?", J Oral Maxillofac Surg, 80(9), pp.1550~1556 (2022)
- McGurk M, "Extracapsular dissection for clinically benign parotid lumps : reduced morbidity without oncological compromise", Br J Cancer, 89(9), pp.1610~1613 (2003)
- Renehan AG, "Clinico-pathological and treatment-related factors influencing survival in parotid cancer", Br J Cancer, 80(8), pp.1296~1300 (1999)
- Carinci F, "Parotid gland carcinoma : 1987 and 1997 UICC T classifications compared for prognostic accuracy at 5 years", Eur Arch Otorhinolaryngol, 258(3), pp.150~154 (2001)
- Gebhardt BJ, "Concurrent chemoradiotherapy in the adjuvant treatment of high-risk primary salivary gland malignancies", Am J Clin Oncol, 41(9), pp.888~893 (2018)
- Amini A, "Association of adjuvant chemoradiotherapy vs radiotherapy alone with survival in patients with resected major salivary gland carcinoma : data from the National Cancer Data Base", JAMA Otolaryngol Head Neck Surg, 142(11), pp.1100~1110 (2016)