Hao Li1,2, Marlena McGill1, Natascha Putri1,3, Avery Yuan1, Richard J Wong1, Snehal G Patel1, Ian Ganly1,4. 1. Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA. 2. Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore. 3. Department of Head and Neck Surgery, National Cancer Center Singapore (NCCS), Singapore, Singapore. 4. Head and Neck Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Abstract
BACKGROUND: Resection of parotid carcinomas involving the parapharyngeal space is challenging. How this affects tumor margin control, recurrence, and survival is unclear. METHODS: Patients who underwent resection of parotid carcinomas between 1985 and 2015 at Memorial Sloan Kettering Cancer Center were evaluated for the impact of parapharyngeal extension (PPE) on margin status, local recurrence-free probability (LRFP), and disease-specific survival (DSS). RESULTS: Out of 214 patients in whom preoperative imaging was available for review, 22 (10.3%) had PPE. Matched by histotypes, carcinomas with PPE had comparable margin positivity (p = 0.479), T classification (p = 0.316), pathologic risk (p = 0.936), and adjuvant therapy (p = 0.617) to those without PPE. The 3-year LRFP was 88.9% versus 95.4% (hazard ratio [HR] 2.23 after adjusting for pT classification, p = 0.342) and the 5-year DSS was 74.2% versus 69.5% (adjusted HR 0.45, p = 0.232) in patients with and without PPE. CONCLUSION: PPE does not appear to worsen oncologic outcomes in the resection of parotid carcinomas.
BACKGROUND: Resection of parotid carcinomas involving the parapharyngeal space is challenging. How this affects tumor margin control, recurrence, and survival is unclear. METHODS: Patients who underwent resection of parotid carcinomas between 1985 and 2015 at Memorial Sloan Kettering Cancer Center were evaluated for the impact of parapharyngeal extension (PPE) on margin status, local recurrence-free probability (LRFP), and disease-specific survival (DSS). RESULTS: Out of 214 patients in whom preoperative imaging was available for review, 22 (10.3%) had PPE. Matched by histotypes, carcinomas with PPE had comparable margin positivity (p = 0.479), T classification (p = 0.316), pathologic risk (p = 0.936), and adjuvant therapy (p = 0.617) to those without PPE. The 3-year LRFP was 88.9% versus 95.4% (hazard ratio [HR] 2.23 after adjusting for pT classification, p = 0.342) and the 5-year DSS was 74.2% versus 69.5% (adjusted HR 0.45, p = 0.232) in patients with and without PPE. CONCLUSION: PPE does not appear to worsen oncologic outcomes in the resection of parotid carcinomas.
Authors: Safina Ali; Frank L Palmer; Changhong Yu; Monica DiLorenzo; Jatin P Shah; Michael W Kattan; Snehal G Patel; Ian Ganly Journal: JAMA Otolaryngol Head Neck Surg Date: 2013-07 Impact factor: 6.223