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Recurrent parotid gland carcinoma: how effective is salvage surgery?

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

Recurrent parotid gland carcinomas (PGCs) are poorly characterized and studies focusing on this topic are rare due to their low incidence. The goal of this study is to analyze the therapeutic strategies, prognostic factors, and oncological outcomes of a series of patients with recurrent PGCs.

Patients and Methods

Retrospective chart review (1997–2012) of patients with recurrent PGCs was initially treated with curative intent.

Results

We identified 20 patients with recurrent PGCs. Eleven patients presented isolated local, regional, or distant metastases, while the rest had recurrences in multiple sites. Recurrent tumors tended to present more advanced T-stage (p = 0.01) and overall stage (p < 0.001), but not N-stage (p = 0.74) when compared to the initial tumors. Half the patients (50%) had distant metastases at the moment of recurrence diagnosis, and another three developed them after attempted salvage surgery. Only 8/20 patients with isolated local or regional recurrences were surgically salvaged with extended revision parotidectomy and neck dissection, respectively. The remaining 12 patients were managed on palliative basis. Overall survival (31.70 months vs. 20.73 months) and progression-free survival (28.70 months vs. 13.61 months) were not significantly different in patients managed surgically vs. palliatively.

Conclusion

Recurrent PGCs are aggressive neoplasms with a high rate of distant metastases. Surgical salvage can be considered in patients with limited local and/or regional recurrences. The alternative to surgical salvage is palliative management with different chemotherapeutic regimens. Survival does not differ between the two strategies in the present series.

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Author information

Author notes

  1. Lluís Nisa and Urs Borner have contributed equally to this work and share co-first authorship.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital Bern, University Hospital, University of Bern, 3010, Bern, Switzerland

    Lluís Nisa, Urs Borner, Cilgia Dür, Andreas Arnold & Roland Giger

  2. Department of Radiation Oncology, Inselspital Bern, University Hospital, University of Bern, Bern, Switzerland

    Lluís Nisa

  3. Department of Biomedical Research, University of Bern, Bern, Switzerland

    Lluís Nisa

Authors
  1. Lluís Nisa
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  2. Urs Borner
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  3. Cilgia Dür
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  4. Andreas Arnold
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  5. Roland Giger
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Corresponding author

Correspondence to Roland Giger.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

For this retrospective study, we obtained approval from our Institutional Review Board and National Ethic Committee. No procedures were performed on patients; only paper- and computer-based records of patients treated between January 1997 and June 2012 were reviewed. All are in accordance with the above-mentioned research committees and with the 1964 Helsinki declaration and its later amendments.

Informed consent

General informed consent was obtained from all individual participants included in the study.

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Nisa, L., Borner, U., Dür, C. et al. Recurrent parotid gland carcinoma: how effective is salvage surgery?. Eur Arch Otorhinolaryngol 275, 507–513 (2018). https://doi.org/10.1007/s00405-017-4829-8

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  • DOI: https://doi.org/10.1007/s00405-017-4829-8

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