Multivariate prediction of the probability of recurrence in patients with carcinoma of the parotid gland

Abstract

BACKGROUNDParotid gland carcinoma is an infrequent tumor, and series that report on these neoplasms are relatively scarce in the literature. The objective of the current study was to identify prognostic factors in patients with parotid gland carcinoma and to develop a method for defining the probability of recurrence.METHODSPatients with parotid gland carcinoma who were treated at the authors' institution from January 1981 through December 2004 and who completed treatment constituted the study group. Disease‐free survival was calculated by using the Kaplan‐Meier method. Logistic regression analysis was employed to define the recurrence‐associated prognostic factors.RESULTSOne hundred twenty‐seven patients were included (64 men and 63 women); their mean age was 53 years. Mucoepidermoid carcinoma was diagnosed in 34.6% of patients, adenoid cystic was diagnosed in 15.7% of patients, adenocarcinoma was diagnosed in 14.3% of patients, and acinic cell carcinoma was diagnosed in 9.4% of patients. The median disease‐free survival was 8.3 years (95% confidence interval [95% CI], 4.3–12.2 years). Logistic regression analysis confirmed tumor classification, facial nerve palsy, grade of tumor differentiation, patient age, and surgical margins as recurrence‐associated factors (P < .00001). Using this model, 3 postoperative risk groups were defined—high‐risk, intermediate‐risk, and low‐risk—that had recurrence frequencies of 71.4%, 43.1%, and 8.8%, respectively (P = .0001). The 5‐year disease‐free survival rates for these groups were 18.7%, 53.9%, and 99.9%, respectively (P = .00001).CONCLUSIONSIn this study, the authors identified several significant prognostic factors. Consequently, they have proposed a prognostic score categorization that allows for a straightforward calculation of the risk of recurrence for a given patient that may help to define therapeutic strategies, target patient counseling, and design future trials. Cancer 2007. © 2007 American Cancer Society.

The prognostic role of comorbidity in salivary gland carcinoma

“…[16][17][18] Most reports deal exclusively with either tumors of the major salivary glands (submandibular and parotid glands combined), or tumors of the minor salivary glands, [19][20][21][22][23][24] or tumors of the parotid gland only. [25][26][27][28][29][30][31][32][33][34] We performed an update of the database of the NWHHT concerning all salivary gland cancers irrespective of site and histology. This analysis, which was based on data from all head and neck centers in the Netherlands, included comorbidity scores.…”

Site-wise Differences in Adequacy of the Surgical resection Margins in Head and Neck Cancers

“…The standard surgical procedure was total parotidectomy with facial nerve preservation unless there was gross neural invasion. Patients who were in poor clinical condition or who had unresectable tumors received radiotherapy as primary treatment [36]. An appropriate resection in malignant parotid tumors would be the resection of the tumor with a sufficient layer of normal parotid tissue around the tumor confirmed per operatively.…”

Rak ślinianki przyusznej: analiza kliniczno-patologiczna oraz ocena wyników leczenia

“…15 Rak płaskonabłonkowy (squamous cell carcinoma) 2. 16 Rak drobnokomórkowy (small cell carcinoma) 2. 17 Rak niezróŜnicowany (undifferenciated carcinoma) 2.…”

“…W innych pracach liczba chorych z dolegliwościami bólowymi waha się od 7% do 59% [11,16,39,43,48,50,77,79,80,85,109,120,124]. Rafla podaje dodatkowo, Ŝe u 6% chorych występowała otalgia, a w materiale Pohara i wsp.…”

“…Odsetek pacjentów z niedowładem lub poraŜeniem nerwu twarzowego według zestawień polskich i światowych jest bardzo zróŜnico-wany [11,16,34,39,43,48,50,55,77,80,85,86,109,120,124] [109]. Naciek skóry występował w naszym materiale u 19,8% chorych (owrzodzenie stwierdzono u 6,1%), wartości te mieszczą się w zakresie występującym w piśmiennictwie -od 9,4% do 28% chorych (owrzodzenie 3% do 9,44%) [11,16,34,80,85,109]. Zaburzenia czucia pod postacią parastezji podawało 9,9% chorych.…”