A Renehan1, E N Gleave, M McGurk. 1. University Department of Surgery, University Hospital of South Manchester, United Kingdom.
Abstract
BACKGROUND: Nerve preserving surgery is widely recommended for recurrent parotid pleomorphic adenomas though the risk of further relapse may be high. Adjuvant radiotherapy may improve control but its exact role requires clarification. METHODS: A series of 114 patients with first recurrences treated between 1952 and 1992 is reviewed. Treatment modality was either surgery alone (SG; n = 63) or surgery with radiotherapy (SG + RT; n = 51). Results were determined with respect to long-term tumor control (K-M life-tables) and facial nerve function. RESULTS: The rate to second recurrence was 15% (17/114), median follow-up 14 years. There were no cases of malignant degeneration. Multinodular recurrences treated by SG were at particular high risk of relapse, but control was significantly improved with adjuvant radiotherapy (SG versus SG = RT; 43% versus 4% at 15 years, P = 0.008). In contrast, no difference was demonstrated in the uninodular tumor group (SG versus SG = RT; 15% versus 13% at 15 years, P = 0.9). The incidence of permanent facial nerve injury was 15%. CONCLUSIONS: This study emphasizes the distinction between multinodular and uninodular recurrences; the former is at high risk of relapse and benefits from adjuvant radiotherapy whereas solitary tumors may be adequately treated by surgery alone.
BACKGROUND: Nerve preserving surgery is widely recommended for recurrent parotid pleomorphic adenomas though the risk of further relapse may be high. Adjuvant radiotherapy may improve control but its exact role requires clarification. METHODS: A series of 114 patients with first recurrences treated between 1952 and 1992 is reviewed. Treatment modality was either surgery alone (SG; n = 63) or surgery with radiotherapy (SG + RT; n = 51). Results were determined with respect to long-term tumor control (K-M life-tables) and facial nerve function. RESULTS: The rate to second recurrence was 15% (17/114), median follow-up 14 years. There were no cases of malignant degeneration. Multinodular recurrences treated by SG were at particular high risk of relapse, but control was significantly improved with adjuvant radiotherapy (SG versus SG = RT; 43% versus 4% at 15 years, P = 0.008). In contrast, no difference was demonstrated in the uninodular tumor group (SG versus SG = RT; 15% versus 13% at 15 years, P = 0.9). The incidence of permanent facial nerve injury was 15%. CONCLUSIONS: This study emphasizes the distinction between multinodular and uninodular recurrences; the former is at high risk of relapse and benefits from adjuvant radiotherapy whereas solitary tumors may be adequately treated by surgery alone.
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
Authors: Sarah E Nicholas; Wei Fu; Angela L Liang; Regina DeLuna; Luka Vujaskovic; Justin Bishop; Brandi R Page; Harry Quon; Christine Gourin; Carole Fakhry; David Eisele; Ana P Kiess Journal: Adv Radiat Oncol Date: 2021-03-02