Unremarkable parotid tumours that prove to be malignant

Previous studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tumour masquerades as a clinically benign lump, this approach may be inappropriate. This study addressed this question by analysing the outcome of 821 consecutive patients with parotid tumours treated at one centre over 40 years and with a median 12 (range 5 -30) years follow-up. Tumours were classified as 'simple' (discrete, mobile, o 4 cm: n ¼ 662) and 'complex' (deep, fixed, facial nerve palsy, X4 cm: n ¼ 159). Among the 'simple' or clinically benign tumours, 503 patients underwent ECD; 159 patients underwent SP. In all, 32 (5%) clinically benign cases were subsequently revealed as malignant histologies (ECD, 12; SP, 20). For each group, 5-and 10-year cancer-specific survival rates were 100 and 98%, respectively. There were no differences in recurrence rates when subanalysed by surgical groups, but ECD was associated with significantly reduced morbidity (P o 0.001). This study demonstrates that ECD is a viable alternative to superficial parotidectomy for the majority of parotid tumours, associated with reduced morbidity without oncological compromise.

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Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise

McGurk¹,

Thomas²,

2003

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Contemporary Management of Benign and Malignant Parotid Tumors

Thielker

Grosheva

Ihrler³

et al. 2018

Front. Surg.

103

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To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors.Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors.Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes.The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.

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Unremarkable parotid tumours that prove to be malignant

Cited by 2 publications

References 14 publications

Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise

Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise

Contemporary Management of Benign and Malignant Parotid Tumors

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