Oncological outcomes of preoperatively unexpected malignant tumors of the parotid gland
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HEAD AND NECK
Oncological outcomes of preoperatively unexpected malignant tumors of the parotid gland Hanaro Park1 · Sungjun Han2 · Sung Joon Park3 · Young Ho Jung4 · Soon‑Hyun Ahn4,5 · Woo‑Jin Jeong4 Received: 30 March 2020 / Accepted: 20 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Unexpected parotid cancers are often encountered due to inaccuracies in the preoperative evaluation. This study aimed to examine the clinical characteristics and oncological outcomes of these cancers and to propose the appropriate management strategy. Methods This is a multicenter case series study in which a total of 302 patients were diagnosed postoperatively with parotid cancers between 2003 and 2017. Of these, 85 cases without evidence of malignancy prior to surgery but identified as malignant on postoperative pathology were included. Results Of 85 patients, 76 and 9 underwent superficial and total parotidectomy, respectively. A positive resection margin was present in 24.7% of the cases. Postoperative radiotherapy was administered to 43.6% of patients; 4.2% had a local recurrence, and no patients died of the disease. The 5-year overall and relapse-free survival rates were 100.0% and 95.2%, respectively. Patients who underwent piecemeal resection had significantly poorer oncologic outcomes. Age, sex, histologic grade, T stage, extracapsular extension, resection margin status, and postoperative radiotherapy did not affect recurrence and survival. Conclusion Preoperatively unexpected parotid cancers had excellent local control and overall survival despite positive or close resection margin, with or without postoperative radiotherapy. Therefore, patients with unexpected parotid malignancies may benefit from less aggressive postoperative management option. Keywords Parotid cancers · Preoperative biopsy · Adjuvant radiotherapy · Outcome · Recurrence
Introduction
* Woo‑Jin Jeong [email protected] 1
Department of Otorhinolaryngology‑Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
2
Department of Otorhinolaryngology‑Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
3
Department of Otorhinolaryngology‑Head and Neck Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
4
Department of Otorhinolaryngology‑Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
5
Department of Otorhinolaryngology‑Head and Neck Surgery, Seoul National University Hospital, Seoul National University, College of Medicine, Seoul, South Korea
Malignant tumors of the parotid gland represent 1–3% of all head and neck tumors [1]. When treated with appropriate surgery, patients have a good chance of recovery and retaining normal facial nerve function. Surgical planning and decisions on whether to perform superficial parotidectomy or total paroti
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