Clinical History, Prognostic Factors, and Management of Facial Nerve in Malignant Tumors of the Parotid Gland

Abstract

ObjectivesWe analyzed the outcomes following clinical management of parotid masses that were determined to be malignant tumors after parotidectomy.MethodsWe evaluated data from 70 patients with parotid malignancies between November 1994 and December 2005.ResultsAmong salivary histotypes (n=49), the most significant prognostic parameter was cT4 stage at diagnosis (P=0.0055, log-rank) both for clinical involvement of the facial nerve and for invasion of other structures. The main cause of cancer-related death was a distant metastasis.ConclusionThe present series confirms that the main prognostic parameter in salivary parotid malignancies was cT4 classification at diagnosis, often due to clinical involvement of the facial nerve. The oncological outcome of salivary malignancies was influenced by distant metastasis more than most other head and neck sites. We recommend dissecting and preserving the functioning VIIth cranial nerve during surgery for parotid malignancies.

Incidence and risk factors of late recurrence in patients with salivary gland cancer

“…Many studies have investigated the factors that can affect survival outcome in patients with SGC. The significant clinical and pathologic factors found in our study, including age, gender, TNM staging, histologic grade, EPE, PNI, LVI and resection margins, are in line with those reported by previous studies . Multivariable analysis revealed that a non‐parotid tumour site, high histologic grade, EPE and N2 classification were independent factors of survival.…”

Association Between Facial Nerve Monitoring With Postoperative Facial Paralysis in Parotidectomy

“…A higher morbidity and mortality rate in parotid malignant neoplasms is usually associated with cT4 classifications at diagnosis and, as mentioned, with clinical involvement of the facial nerve. 27,28 Such cases were not present in our cohorts. Facial nerve monitoring does not replace a keen knowledge of facial nerve anatomy and appropriate surgical training.…”

Detection of distant metastasis and prognostic prediction of recurrent salivary gland carcinomas using 18F‐FDG PET/CT

“…The current study also demonstrated the prognostic value of PET‐positive findings at distant sites. Prior studies demonstrated risk factors influencing SGC survival, with tumor size, histological grade, N classification, and distant metastases reported as being associated with cancer‐specific survival and OS outcomes (Ali et al., , ; Bussu et al., ; Roh et al., , ). The metastatic potential of SGC differs substantially according to different sites, pathology, and histological grade (Ali et al., ; Cheung, Franzmann, Sola, Pincus, & Koniaris, ; Ko et al., ; Nam et al., ).…”

“…The most common site for distant metastasis was the lung, with the proportion ranging from 50% to 78%, while metastases in multiple organs were also very common (Ali et al, 2015;Nam et al, 2016). Therefore, posttreatment surveil- (Ali et al, 2014(Ali et al, , 2015Bussu et al, 2014;Roh et al, 2008Roh et al, , 2014. The metastatic potential of SGC differs substantially according to different sites, pathology, and histological grade (Ali et al, 2015;Cheung, Franzmann, Sola, Pincus, & Koniaris, 2011;Ko et al, 2007;Nam et al, 2016).…”