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
Summary
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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