Abstract

(1) Background: Lateral or total parotidectomy are the standard surgical treatments for malignant parotid tumors. However, some authors have proposed a more limited procedure. (2) Methods: We performed a review of the literature on this topic. Studies were included that met the following criteria: malignant parotid tumors, information about the extent of surgical resection, treated with less than a complete lateral lobectomy, and information on local control and/or survival. Nine articles fulfilled the inclusion criteria. (3) Results: Eight of the nine series reported favorable results for the more limited approaches. Most used them for small, mobile, low-grade cancers in the lateral parotid lobe. Most authors have used a limited partial lateral lobectomy for a presumed benign lesion. The remaining study analyzed pediatric patients treated with enucleation with poor local control. (4) Conclusions: There is weak evidence for recommending less extensive procedures than a lateral parotid lobectomy. In the unique case of a partial lateral parotidectomy performed for a tumor initially thought to be benign but pathologically proved to be malignant, close follow-up can be recommended for low grade T1 that has been excised with free margins and does not have adverse prognostic factors.

Highlights

  • Surgery is considered the primary treatment modality for most malignant parotid tumors.The extent of the surgery depends mainly on the local extent of the disease [1,2,3,4,5,6,7,8,9,10]

  • The most frequent surgical approach was total parotidectomy (65%), but a number were treated with enucleation (22%) and the remainder with lateral lobectomy (10%)

  • The object of this review was to analyze the role of limited surgery in the treatment of primary malignant parotid tumors

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Summary

Introduction

Surgery is considered the primary treatment modality for most malignant parotid tumors.The extent of the surgery depends mainly on the local extent of the disease [1,2,3,4,5,6,7,8,9,10]. One debated issue is whether to extirpate the deep lobe of the gland to remove the intraparotid deep lobe nodes [1,2,3,4,5,6,7,8,9,10] This is done when there is evidence of superficial parotid or neck node metastasis from a parotid gland cancer, or if the tumor is of high-grade histology. Controversy regarding the extent of the gland to be removed occurs as some recommend [11] a more limited resection than complete lateral lobectomy. When limited parotid surgery is done for a presumably benign tumor, and final histology reveals malignancy, subsequent treatment is often dictated by the final pathologic findings. The standard advice is to complete a total parotidectomy [1,2,3,4,5,6,7,8]

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