Sameep Kadakia1, Yadranko Ducic2, Diego Marra3, Masoud Saman4. 1. Department of Otolaryngology-Head and Neck Surgery, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA. 2. Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Avenue, Suite 100, Fort Worth, TX, 76104, USA. yducic@sbcglobal.net. 3. Mohs Surgery Private Practice, Fort Worth, TX, USA. 4. Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Avenue, Suite 100, Fort Worth, TX, 76104, USA.
Abstract
OBJECTIVE: In order to determine rates of metastasis and efficacy of elective superficial parotidectomy, we examine parotid specimens in patients with temporal region cutaneous squamous cell carcinoma treated with local excision and ipsilateral parotidectomy. STUDY DESIGN: This paper is a retrospective review. SETTING: This study was conducted at a private tertiary referral practice in Fort Worth, Texas, from 1998 to 2013. SUBJECTS AND METHODS: Ninety-three patients between ages 27 and 98 with primary squamous cell carcinoma of the temporal region greater than or equal to 2 cm were included in this study. Subjects had no evidence of adenopathy or parotid involvement on exam or imaging. Patients were treated with local excision and ipsilateral parotidectomy. The primary tumor was studied for vascular involvement and perineural invasion while the parotid specimen was analyzed for occult cancer. Patients were post-operatively followed for a minimum of three years. RESULTS: Twenty-three (24.7 %) parotid samples were found to harbor occult malignancy. Of these, nine (39.1 %) patients had vascular involvement of the primary tumor and 14 (60.8 %) had perineural invasion. Thirteen out of 58 affected males and 10 out of 35 affected females were found to have intraparotid node positivity. Vascular involvement (p = 0.0004) and perineural invasion (p = 0.0001) in the primary malignancy were found to be greater in patients with positive specimen. Sex was not statistically significant. CONCLUSIONS: In patients with cutaneous squamous cell carcinoma of the temporal region at least 2 cm in size, elective superficial parotidectomy may be a beneficial part of treatment, especially in primary tumors showing perineural and/or vascular involvement. LEVEL OF EVIDENCE: Level 2b (retrospective cohort).
OBJECTIVE: In order to determine rates of metastasis and efficacy of elective superficial parotidectomy, we examine parotid specimens in patients with temporal region cutaneous squamous cell carcinoma treated with local excision and ipsilateral parotidectomy. STUDY DESIGN: This paper is a retrospective review. SETTING: This study was conducted at a private tertiary referral practice in Fort Worth, Texas, from 1998 to 2013. SUBJECTS AND METHODS: Ninety-three patients between ages 27 and 98 with primary squamous cell carcinoma of the temporal region greater than or equal to 2 cm were included in this study. Subjects had no evidence of adenopathy or parotid involvement on exam or imaging. Patients were treated with local excision and ipsilateral parotidectomy. The primary tumor was studied for vascular involvement and perineural invasion while the parotid specimen was analyzed for occult cancer. Patients were post-operatively followed for a minimum of three years. RESULTS: Twenty-three (24.7 %) parotid samples were found to harbor occult malignancy. Of these, nine (39.1 %) patients had vascular involvement of the primary tumor and 14 (60.8 %) had perineural invasion. Thirteen out of 58 affected males and 10 out of 35 affected females were found to have intraparotid node positivity. Vascular involvement (p = 0.0004) and perineural invasion (p = 0.0001) in the primary malignancy were found to be greater in patients with positive specimen. Sex was not statistically significant. CONCLUSIONS: In patients with cutaneous squamous cell carcinoma of the temporal region at least 2 cm in size, elective superficial parotidectomy may be a beneficial part of treatment, especially in primary tumors showing perineural and/or vascular involvement. LEVEL OF EVIDENCE: Level 2b (retrospective cohort).
Authors: Brian A Moore; Randal S Weber; Victor Prieto; Adel El-Naggar; F Christopher Holsinger; Xian Zhou; J Jack Lee; Scott Lippman; Gary L Clayman Journal: Laryngoscope Date: 2005-09 Impact factor: 3.325
Authors: Jennifer L Andruchow; Michael J Veness; Gary J Morgan; Kan Gao; Anthony Clifford; Kerwin F Shannon; Michael Poulsen; Lizbeth Kenny; Carsten E Palme; Patrick Gullane; Christopher Morris; William M Mendenhall; Kepal N Patel; Jatin P Shah; Christopher J O'Brien Journal: Cancer Date: 2006-03-01 Impact factor: 6.860