Evaluation of Prognostic Factors for the Parotid Cancer Treated With Surgery and Postoperative Radiotherapy

Abstract

Objectives. To investigate the prognostic factors and treatment outcomes of primary parotid carcinoma treated with surgery and postoperative radiotherapy (PORT).Methods. We reviewed retrospectively 57 patients with primary parotid carcinoma who were treated with surgery and PORT between 2005 and 2014. Superficial parotidectomy was performed in 19 patients, total parotidectomy in 10 patients, and total parotidectomy with lymph node dissection in 28 patients PORT on the tumor bed was performed in 41 patients, while PORT on tumor bed and ipsilateral cervical lymph nodes was performed in 16 patients.Results. With a median follow-up of 66 months, the 5-year overall survival, disease-free survival, locoregional control, and distant control rates were 77.0%, 60.2%, 77.6%, and 72.8%, respectively. The 5-year overall survival by stage was 100%, 100%, 80.0%, and 46.4% in stage I, II, III, and IV, respectively. Recurrences at primary lesions were found in seven patients, while at cervical nodes in six patients. Distant recurrences were developed in 12 patients. No patient with the low and intermediate histologic grade developed distant failure. As prognostic factors, the histologic grade for overall survival (P=0.005), pathological T-stage (P=0.009) and differentiation grade (P=0.009) for disease-free survival, pathological T-stage for locoregional control (P=0.007), and lympho-vascular invasion (P=0.023) for distant recurrence were significant on multivariate analysis.Conclusion. This study revealed that differentiation grade, histologic grade, pathological T-stage, and lympho-vascular invasion were significant independent prognostic factors on clinical outcomes.

Prognostic Value of the Lymphocyte‐to‐Monocyte Ratio in Patients with Parotid Gland Carcinoma

“…Our study demonstrated that the 5‐year OS and DFS among patients with PGC who underwent curative treatment were 73.1% and 62.8%, respectively. These rates were previously reported to be 46% to 82.9% 1,3‐6,21–24 and 60.2% to 74.4%, 3–5,25 respectively; our results are consistent with those of previous studies, given that the treatment protocol at our institution is based on the National Comprehensive Cancer Network guidelines for head and neck cancers 26…”

“…Owing to its low incidence and histological diversity, the prognoses of patients with PGC remain unclear. Previous studies have revealed that prognostic factors for such patients include age, 3 TNM classification, 1,4 preoperative facial paralysis, 5 high‐risk histology, 6 perineural invasion, 5 lymphovascular invasion, 4 and surgical margin 5 …”

Alpha-Lipoic Acid Ameliorates Radiation-Induced Salivary Gland Injury by Preserving Parasympathetic Innervation in Rats

“…Indeed, the anatomy of gland innervation may, in part, explain the effects of radiation therapy on autonomic nerves. Because the cell bodies of parasympathetic ganglia are located within SGs, they may be more affected by radiation therapy, whereas sympathetic nerve cell bodies are located in the superior cervical ganglion, and are thus distant from the site of radiation therapy [19][20][21][22]. The maintenance of a progenitor cell population as a reservoir of undifferentiated cells is required for the development and regeneration.…”

Prognostic Score and Associations With Survival Improvement Offered by Radiotherapy After Surgery for Adenocarcinomas of Parotid Gland: A Population-based Longitudinal Cohort Study

“…Surgery, radiation with or without chemotherapy and their combination are recommended treatment options for locoregional relapse [12]. Retrospective studies showed that comprehensive treatment strategies can reduce the local recurrence rate by 5-40% [13,14] and postoperative radiotherapy (PORT) was recommended for patients with prognostic risk factors [15,16]. However, the e cacy of adjuvant radiotherapy on speci c patients of parotid adenocarcinoma needs further determined to better screen patients bene tting from PORT, which will be conducive to avoid the additional damage caused by overtreatment.…”