Surgical Outcomes in Primary Parotid Cancer

Abstract

Objectives: Surgeries performed for primary parotid malignancies vary, and the oncologic outcomes are undetermined. This study aims to: (1) Describe surgical outcomes of superficial versus total parotidectomy, and (2) describe surgical outcomes of observation versus cervical lymphadenectomy in patients with a N0 neck. Methods: Records of 129 consecutive patients with non-metastatic primary parotid cancer treated from 1988 to 2010 at the University of Utah and Intermountain Healthcare were reviewed. Treatment was superficial (47%) or total (53%) parotidectomy, 31% underwent concurrent cervical lymphadenectomy, and 67% received adjuvant radiotherapy due to high-risk features. Patient demographics, tumor characteristics, surgical treatments, and oncologic outcomes were statistically analyzed. Results: Average age at diagnosis was 52 years. Mean follow-up was 7.4 years. Patient demographics, tumor grade, and histology were not predictive of recurrence or survival. Matching patients with Stage I/II disease (n = 74) and comparing superficial versus total parotidectomy, there was no difference in 5-year disease free rate, and 5- and 10-year overall survival rates (85%, 95%, and 88% versus 84%, 84% and 67%, respectively). Also, for Stage III (n = 18) and IV (n =33) disease there was no difference. For 101 patients with a N0 neck, 81 were observed and 20 underwent an elective cervical lymphadenectomy; there was no difference in outcomes (76%, 85%, and 72% versus 73%, 87%, and 67%, respectively). Conclusions: Treatment of primary parotid cancer requires meticulous surgical dissection and gross tumor resection; however, superficial versus total parotidectomy or observation versus elective cervical lymphadenectomy does not affect tumor recurrence rates or overall survival outcomes.