Giuseppe Colella1, Rosangela Cannavale2, Paolo Chiodini3. 1. Department of Head and Neck Surgery, Second University of Naples, Naples, Italy. Electronic address: giuseppe.colella@unina2.it. 2. Department of Head and Neck Surgery, Second University of Naples, Naples, Italy. 3. Medical Statistics Unit, Second University of Naples, Naples, Italy.
Abstract
INTRODUCTION: Different types of surgical management of pleomorphic adenoma of the parotid gland are associated with different recurrence rates. MATERIAL AND METHODS: A systematic review of literature until 2014 with meta-analysis was conducted. Inclusion criteria were original studies of patients with surgical management for pleomorphic adenoma of the parotid gland and recurrence rates, with a median follow-up period of 5 years. The Newcastle-Ottawa Quality Assessment Scale (NOQAS) was used to assess the quality. RESULTS: Sixteen studies were included. Four studies show a low recurrence rate (0.01, 95% confidence interval [CI] = 0.00-0.02) after total parotidectomy. Twelve studies show a low recurrence rate (0.02, 95% CI = 0.01-0.03) after superficial parotidectomy. Six studies show a low recurrence rate (0.02, 95% CI = 0.01-0.04) after limited parotidectomy. Six studies demonstrate a low recurrence rate (0.01, 95% CI = 0.00-0.04) after extracapsular dissection. Five studies report a low-to-medium recurrence rate (0.08, 95% CI = 0.03-0.14) after extracapsular enucleation. CONCLUSION: Information about recurrence rates, times of recurrence in relation to type of surgical treatment, and significance of capsule rupture is very poor. With regard to recurrence rates and surgical approaches, the types of operations that show the lowest recurrence rate are total parotidectomy and extracapsular dissection. Controversies over surgical treatment of PA of parotid gland remain, and the safest surgical method for the removal of this tumors has not been identified.
INTRODUCTION: Different types of surgical management of pleomorphic adenoma of the parotid gland are associated with different recurrence rates. MATERIAL AND METHODS: A systematic review of literature until 2014 with meta-analysis was conducted. Inclusion criteria were original studies of patients with surgical management for pleomorphic adenoma of the parotid gland and recurrence rates, with a median follow-up period of 5 years. The Newcastle-Ottawa Quality Assessment Scale (NOQAS) was used to assess the quality. RESULTS: Sixteen studies were included. Four studies show a low recurrence rate (0.01, 95% confidence interval [CI] = 0.00-0.02) after total parotidectomy. Twelve studies show a low recurrence rate (0.02, 95% CI = 0.01-0.03) after superficial parotidectomy. Six studies show a low recurrence rate (0.02, 95% CI = 0.01-0.04) after limited parotidectomy. Six studies demonstrate a low recurrence rate (0.01, 95% CI = 0.00-0.04) after extracapsular dissection. Five studies report a low-to-medium recurrence rate (0.08, 95% CI = 0.03-0.14) after extracapsular enucleation. CONCLUSION: Information about recurrence rates, times of recurrence in relation to type of surgical treatment, and significance of capsule rupture is very poor. With regard to recurrence rates and surgical approaches, the types of operations that show the lowest recurrence rate are total parotidectomy and extracapsular dissection. Controversies over surgical treatment of PA of parotid gland remain, and the safest surgical method for the removal of this tumors has not been identified.
Authors: Bayan Alzumaili; Bin Xu; Maelle Saliba; Abderhman Abuhashem; Ian Ganly; Ronald Ghossein; Nora Katabi Journal: Am J Surg Pathol Date: 2021-11-15 Impact factor: 6.298