Comparison of Short-Term Outcomes Following Surgical Intervention of Salivary Gland Malignancies in Adult and Pediatric Patients: A National Database Analysis

Abstract

Background: Salivary gland malignancy (SGM) is a rare surgical pathology in the pediatric population, with currently ambiguous surgical management guidelines for the pediatric population. Therefore, we aim to use a national database to provide demographical and episode-of-care comparisons between the adult and pediatric population suffering from SGMs, with the interest of discovering baseline characteristic differences and outcomes, in addition to assessing the overall level of reporting at a national scale. Methods: The 2012 to 2019 American College of Surgeons’ National Surgical Quality Improvement Program Adult and Pediatric (ACS NSQIP, NSQIP-P) databases were queried to identify diagnoses of salivary gland malignancies based on postoperative ICD-10 codes. Age was stratified into adult (age ≥ 22 years) or pediatric (age < 22 years). Each age-based cohort were further stratified based on cancer site. Demographics, comorbidities, and complications were compared between adults and children. Results: Overall, 1967 adult and 67 pediatric cases were included. Parotid gland malignancy comprised the majority of both adult and pediatric cases. Within cases of parotid gland malignancies, there were proportionally more adult compared to pediatric males. A lower comorbidity burden was also noted across pediatric cases. Operative time was slightly lower for pediatric cases compared to adult, with roughly 1 day less of total hospital stay. Complication rates were similar between adult and pediatric cases without statistically significant difference. Conclusions: Documentation of surgical outcomes in children with SGMs is severely lacking and continued reporting is imperative in order to improve outcomes of both oncologic and necessary reconstructive surgery. Optimal management of pediatric SGM demands use of a longitudinal multidisciplinary approach by surgeons cross-trained in head and neck surgery and plastic surgery. This is a burgeoning field with a need for studies aimed at developing guidelines specific for children.