2022 Volume 115 Issue 9 Pages 771-778
We analyzed the clinical profiles of 42 patients who had been diagnosed as having parotid cancer and were treated initially by surgery between 1999 and 2019, and examined the treatment results and prognostic factors influencing the disease-specific survival (DSS) rate in the 27 patients who had been followed up for more than five years (including deaths within five years).
Preoperative diagnosis of parotid cancers is challenging, because the condition is rare, with diverse histologic types. The sensitivity of fine-needle aspiration cytology (FNAC) for the diagnosis of malignancy was 40.6%, and the accuracy rate of diagnosis of the histopathological type was 14.3%. The sensitivity of operative rapid pathologic diagnosis of malignancy was 91.7%, and the accuracy rate of diagnosis of the histological type was 39.5%. The preoperative accuracy rates of diagnosis of the histological type were low.
According to the UICC TNM classification, 8th edition, the tumor stage was classified as T1, T2, T3 and T4 in 7, 15, 9, and 11 patients, respectively, and nodal involvement was classified as N0, N1, and N2 in 33, three, and six patients, respectively. The most common histopathological type was adenoid cystic carcinoma (10 patients, 24%), followed by mucoepidermoid carcinoma (8 patients, 19%). Local recurrence, neck recurrence, and distant metastasis developed in 7 (17%), 6 (14%), and 14 (33%) of the 42 cases, respectively. In most cases (86%), the distant metastases were in the lungs.
In the 27 patients who could be followed up for more than 5 years, the 5-year disease-specific survival rate was 61.4%, and the 10-year disease-specific survival rate was 45.5%. Univariate analysis identified presence/absence of preoperative pain (presence), presence/absence preoperative facial paralysis (presence), histologic type (high-grade), clinical T grade (T3 and T4), and clinical Stage (III and IV) as being significant determinants of the DSS, with the conditions listed within the parentheses being associated with a poorer DSS.
