Keigo Honda1, Shinzo Tanaka2, Shogo Shinohara3, Ryo Asato4, Hisanobu Tamaki5, Toshiki Maetani6, Ichiro Tateya7, Morimasa Kitamura7, Shinji Takebayashi3, Kazuyuki Ichimaru8, Yoshiharu Kitani9, Yohei Kumabe10, Tsuyoshi Kojima11, Koji Ushiro12, Masanobu Mizuta7, Koichiro Yamada13, Koichi Omori7. 1. Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan. Electronic address: kegohonda@kankyo.ne.jp. 2. Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan. 3. Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Hyogo, Japan. 4. Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 5. Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Okayama, Japan. 6. Department of Otolaryngology - Head and Neck Surgery, Medical Research Institute Kitano Hospital, Osaka, Japan. 7. Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 8. Department of Otolaryngology - Head & Neck Surgery, Kokura Memorial Hospital, Fukuoka, Japan. 9. Department of Otorhinolaryngology - Head & Neck surgery, Shizuoka General Hospital, Shizuoka, Japan. 10. Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaksi General Medical Center, Hyogo, Japan. 11. Department of Otolaryngology, Tenri Hospital, Nara, Japan. 12. Department of Otolaryngology, Japanese Red Cross Otsu Hospital, Shiga, Japan. 13. Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
Abstract
BACKGROUND: Parotid gland carcinoma is a rare malignancy, comprising only 1-4% of head and neck carcinomas; therefore, it is difficult for a single institution to perform meaningful analysis on its clinical characteristics. The aim of this study was to update the clinical knowledge of this rare disease by a multi-center approach. METHODS: The study was conducted by the Kyoto University Hospital and Affiliated Facilities Head and Neck Clinical Oncology Group (Kyoto-HNOG). A total of 195 patients with parotid gland carcinoma who had been surgically treated with curative intent between 2006 and 2015 were retrospectively reviewed. Clinical results including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), local control rate (LCR), regional control rate (RCR), and distant metastasis-free survival (DMFS) were estimated. Univariate and multivariate analyses were performed to identify prognostic factors. RESULTS: The median patient age was 63years old (range 9-93years), and the median observation period was 39months. The OS, DFS, DSS, LCR, RCR, and DMFS at 3years were 85%, 74%, 89%, 92%, 88%, and 87%, respectively. Univariate analysis showed age over 74, T4, N+, preoperative facial palsy, high grade histology, perineural invasion, and vascular invasion were associated with poor OS. N+ and high grade histology were independent factors in multivariate analysis. In subgroup analysis, postoperative radiotherapy was associated with better OS in high risk patients. CONCLUSION: Nodal metastases and high grade histology are important negative prognostic factors for OS. Postoperative radiotherapy is recommended in patients with advanced high grade carcinoma.
BACKGROUND:Parotid gland carcinoma is a rare malignancy, comprising only 1-4% of head and neck carcinomas; therefore, it is difficult for a single institution to perform meaningful analysis on its clinical characteristics. The aim of this study was to update the clinical knowledge of this rare disease by a multi-center approach. METHODS: The study was conducted by the Kyoto University Hospital and Affiliated Facilities Head and Neck Clinical Oncology Group (Kyoto-HNOG). A total of 195 patients with parotid gland carcinoma who had been surgically treated with curative intent between 2006 and 2015 were retrospectively reviewed. Clinical results including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), local control rate (LCR), regional control rate (RCR), and distant metastasis-free survival (DMFS) were estimated. Univariate and multivariate analyses were performed to identify prognostic factors. RESULTS: The median patient age was 63years old (range 9-93years), and the median observation period was 39months. The OS, DFS, DSS, LCR, RCR, and DMFS at 3years were 85%, 74%, 89%, 92%, 88%, and 87%, respectively. Univariate analysis showed age over 74, T4, N+, preoperative facial palsy, high grade histology, perineural invasion, and vascular invasion were associated with poor OS. N+ and high grade histology were independent factors in multivariate analysis. In subgroup analysis, postoperative radiotherapy was associated with better OS in high risk patients. CONCLUSION: Nodal metastases and high grade histology are important negative prognostic factors for OS. Postoperative radiotherapy is recommended in patients with advanced high grade carcinoma.