Clasificación pronóstica de los tumores malignos de glándula parótida

Abstract

ObjectiveThe histological classification of the World Health Organization (WHO), along with improved imaging studies, provide relevant information for the management of parotid carcinomas. However, the prognosis depends on factors other than histology and tumor extension. This article evaluates the usefulness of a prognostic classification of parotid cancers, including these factors in patients in a hospital area. MethodsA follow-up was conducted on 19 patients with parotid carcinomas, excluding lymphoid tumors or intra-parotid metastases, between 1998 and 2012. The prognostic index was obtained from the formulas proposed by Vander Poorten, with factors including age, tumor size, lymph node involvement, skin invasion, facial nerve involvement, perineural growth and margins of resection, before surgery (PS1) and after (PS2). Overall survival was related to 5 years for each patient based on their inclusion in any of the 4 risk groups defined. ResultsRisk stratification based on the results Vander Poorten PS2 was distributed into Risk Groups (GR) 1 (3 patients, 15.7%), 2 (5 patients, 26.3%), 3 (1 patient, 5.8%) and 4 (10 patients, 52.2%). The 6 patients who died during follow-up belonged to GR4. Only one of the 4 patients belonging to GR4 has exceeded the 5-year survival up to the current time.The comparison of the values that relate the pretreatment (PS1) and after treatment (PS2) results showed overall survival in patients with PS1<4.5 and PS2<4.9, whereas mortality was greater with indices of PS1>6.5 and PS2>7.7. ConclusionsVander Poorten index can be applied in hospital areas with small numbers of parotid carcinomas. It enables a more accurate prognosis for individual patients.