Parotid squamous cell carcinoma: Outcome of multidisplinary management

Abstract

Purpose : To evaluate the origin and outcome of parotid squamous cell carcinoma (SCC) Methods and patients : Fifty nine patients were identified with parotid SCC through the hospital data-base, patients’ charts, imaging studies and computerized notes. Results : Fifty of the patients were diagnosed as metastatic SCC from skin primary cancer to parotid lymph nodes; 28% were immunocompromized and 9 patients were diagnosed as primary SCC of the parotid gland, none was immunocompromized. Forty seven patients with metastatic SCC were treated with surgery and post-operative radiotherapy. The rate of neck lymph node metastases was 54%. The median follow up of these patients was 33 months and the 3-year actuarial cause specific survival was 91%. The 3-year actuarial local recurrence free survival (LRFS) and disease free survival rate were 79% and 77% respectively. Positive surgical margin after parotidectomy was the only factor that had statistically significant poor LRFS. Patients with primary parotid SCC had DFS of 100%. Conclusion : The most common site of the primary tumor was a cutaneous SCC of the face. All patients should be considered for facial nerve sparing radical parotidectomy and adjuvant radiotherapy. Neck dissection or elective neck irradiation for ipsilateral neck is recommended due to high occult LN metastasis.