Original contribution
Parotid tumors: a 10-year experience

https://doi.org/10.1016/j.amjoto.2007.03.002Get rights and content

Abstract

Purpose

The aim of the present study was to analyze the clinical presentation, histopathology, and complications of parotid tumors, as well as the management of malignant parotid tumors.

Methods

We retrospectively reviewed the medical records of 271 patients who underwent parotidectomy from August 1996 to July 2006. Data including age, sex, clinical signs and symptoms, histologic findings, complications, malignant tumor stage, and prognosis were collected from medical charts.

Results

Of the 271 patients who underwent parotidectomy, 229 (85%) had benign tumors, 33 (12%) had malignant tumors, and 9 had chronic inflammatory disease (3%). The most common benign tumor was pleomorphic adenoma (51%), and the most common malignant tumor was mucoepidermoid carcinoma (3%). The 5-year overall survival rate was 42%, and the disease-specific survival rate for malignant tumor was 72%. Only disease stage was the statistically significant prognostic factor of malignancy. The most common complication of parotidectomy was transient facial palsy (18%).

Conclusions

Standardized superficial and total parotidectomy are safe procedures for treating parotid tumors. Management of malignant tumors depends on tumor stage and histologic grade. Advanced tumor stage is a predictor of poor outcome.

Introduction

Salivary gland neoplasms account for 3% of all head and neck tumors. About 70% to 80% of all salivary gland tumors are located in the parotid gland [1], [2]. About 80% of parotid masses are benign neoplasms [3]. Parotidectomy is a common surgical procedure for parotid tumor. This study was to respectively review patients treated for parotid tumor in a 10-year period in a tertiary medical center located at mid-Taiwan. The objective was to analyze the clinical presentation, histopathology, complications of parotid tumors, and management of malignant parotid tumors.

Section snippets

Materials and methods

The medical records of 271 patients who underwent parotidectomy at the China Medical University Hospital from August 1996 to July 2006 were reviewed. All operations were either performed or supervised by the same surgeon (Dr Tsai). Superficial parotidectomy was performed if a benign tumor was located in the superficial lobe, and total parotidectomy was performed if it was in the deep lobe. Neither tumor enucleation nor conservative parotidectomy was performed. Management of malignant tumors

Results

A total of 271 patients underwent partoidectomy from August 1996 to July 2006. Of these patients, 229 (85%) had benign tumors, 33 (12%) had malignant tumors, and 9 had chronic inflammatory disease (3%) (Table 1). Most patients with benign tumors had pleomorphic adenoma (51%), followed by Warthin's tumor (23%). Among patients with benign tumors, 3 of them had 2 kinds of tumor synchronously. There were 2 of them that had coexisting pleomorphic adenoma and Warthin's tumor, and 1 that had

Comparison of the histolopathologic finding

The prevalence of Warthin's tumor in this study was higher (23%) than that reported in other series (5%–20%) [3], [4], [5]. However, the most common benign parotid tumor was pleomorphic adenoma (51%) in our study, a finding consistent with previous studies [3], [4], [5]. Lim et al [6] was the first to report that the most common benign parotid tumor is Warthin's tumor (40%) and not pleomorphic adenoma (36%) in Singapore; however, the sample size in their study was small (118 cases). The high

Conclusion

A comprehensive understanding of the anatomy of facial nerve and surgical procedures contributes to the safety and low morbidity of parotid surgery. Advanced tumor stage is a predictor of poor outcome. More research is needed in target therapy or chemotherapy for the patients with malignant parotid tumor.

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