Clinical review of cases with parotid tumors

Abstract

We report a clinical review of 212 cases whose parotid tumors had been treated at our department between April 1991 and May 2008. Their age, gender, histological type, stage classification, and surgical methods were reviewed and then the results of treatment and diagnostic methods were discussed with bibliographical study. Mean age of benign cases was 51.4 years old and that of malignant cases was 55.9 years old. The number of cases was 194 (92 men and 102 women) and 17 (9 men and 8 women), respectively. Eighty-six percent of histological types were pleomorphic adenoma and Warthin's tumor. Eight percent were parotid carcinomas, including mucoepidermoid, adenoid cystic, and adenoid carcinomas. Treatment was selected for each case from surgical operation, post-operative radiotherapy, chemotherapy, and combined therapy. The five-year survival rate of parotid carcinomas was 63.0%. Five cases with poor outcome showed higher stages of disease and higher grade of tumor. Two of them showed pre-operative metastasis and two other cases had facial nerve dysfunction. Based on the evaluation of poor outcome cases as well as bibliographical study, we finally concluded that significant prognostic factors for patients with primary parotid carcinoma are: stage of disease, grade of tumor, pre-operative metastasis, and facial nerve dysfunction. As for availability of fine needle aspiration cytology for preoperative diagnosis, a comprehensive diagnosis including clinical symptoms, image data, and pathological findings of frozen section is required, because we found a few false negative cases.