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Ghenni S, Del Grande J, Gravier Dumonceau R, Haddad R, Giorgi R, Michel J, Fernandez R, Fakhry N. Parotid cancer: analysis of preoperative parameters for adaptation of the therapeutic strategy. Eur Arch Otorhinolaryngol 2024; 281:3207-3218. [PMID: 38568298 DOI: 10.1007/s00405-024-08607-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/06/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To establish typical clinical and radiological profiles of primary low-grade parotid cancers in order to tailor therapeutic strategy. MATERIALS AND METHODS Retrospective study of 57 patients operated on for primary parotid cancer between 2010 and 2021, with review of preoperative MRI and histopathology according to a standardized scoring grid. OBJECTIVE To study prognostic factors and determine the preoperative clinical and radiological profile of low-grade cancers. RESULTS Good prognostic factors for specific survival were: staging ≤ cT3 (p = 0.014), absence of adenopathy on cN0 MRI (p < 0.001), superficial lobe location (p = 0.033), pN0 (p < 0.001), absence of capsular rupture (p = 0.004), as well as the absence of peri-tumoral nodules (p = 0.033), intra-parotid adenopathies (p < 0.001), vascular emboli (p < 0.001), peri-neural sheathing (p = 0.016), nuclear atypia (p = 0.031), and necrosis (p = 0.002). It was not possible to define a reliable clinical and radiological profile for low-grade cancers (sensitivity 38%, specificity 79%). CONCLUSION Our study demonstrated multiple factors of good prognosis, but it was not possible to define a clinical and radiological profile of patients likely to benefit from more limited surgery, nor to diagnose, a priori, low-grade cancers.
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Affiliation(s)
- Samia Ghenni
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, LPL, Marseille, France.
| | - Jean Del Grande
- Department of Anatomopathology, Centre Hospitalier Universitaire (CHU) la Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix Marseille Univ, Marseille, France
| | - Robinson Gravier Dumonceau
- APHM, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Aix Marseille Univ, Marseille, France
| | - Ralph Haddad
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, LPL, Marseille, France
| | - Roch Giorgi
- APHM, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Aix Marseille Univ, Marseille, France
| | - Justin Michel
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, LPL, Marseille, France
- APHM, CNRS, IUSTI, La Conception University Hospital, ENT-HNS Department, Aix Marseille Univ, Marseille, France
| | - Rémi Fernandez
- Department of Radiology, Centre Hospitalier Universitaire (CHU) la Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Aix Marseille Univ, Marseille, France
| | - Nicolas Fakhry
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, LPL, Marseille, France.
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Kawata R, Kinoshita I, Jinnin T, Higashino M, Terada T, Kurisu Y, Hirose Y, Tochizawa T. Clinicopathological characteristics of four major histological types of high-grade parotid carcinoma. Int J Clin Oncol 2023; 28:1597-1606. [PMID: 37831230 DOI: 10.1007/s10147-023-02416-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/17/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE High-grade parotid carcinoma generally has a poor prognosis, and the histological type is mucoepidermoid carcinoma (MEC), salivary duct carcinoma (SDC), carcinoma ex pleomorphic adenoma (CEPA), or adenoid cystic carcinoma (AdCC) in the majority of cases. METHODS During the 23-year period from September 1999 to December 2022, 250 patients with parotid carcinoma underwent initial treatment and had the histopathological type of their carcinoma. Retrospective study evaluated 111 MEC, SDC, CEPA, or AdCC cases among 134 patients with high-grade parotid carcinoma. We examined pathological and clinical features and prognosis, evaluated factors associated with recurrence, and performed immunohistological examinations. RESULTS Pathological and clinical features and factors associated with recurrence were different for each histological type. The 10-year disease-free survival rates were as follows: MEC, 34.9%; SDC, 22.6%; CEPA, 47.1%; and AdCC, 56.3%. Human epidermal growth factor receptor type-2 and androgen receptor were positive in 48% and 56% of patients with SDC, respectively, 38% and 25% of those with CEPA. CONCLUSION Each histological type has its own pathological and clinical features, recurrence types, and tumor activities, suggesting that differentiating between high-grade parotid carcinomas according to histological type will improve diagnosis, and thus prognosis.
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Affiliation(s)
- Ryo Kawata
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
| | - Ichita Kinoshita
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - Tsuyoshi Jinnin
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - Masaaki Higashino
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - Yoshitaka Kurisu
- Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Yoshinobu Hirose
- Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Takeshi Tochizawa
- Institutional Research Office, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
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Ikushima K, Arimura H, Yasumatsu R, Kamezawa H, Ninomiya K. Topology-based radiomic features for prediction of parotid gland cancer malignancy grade in magnetic resonance images. MAGMA (NEW YORK, N.Y.) 2023; 36:767-777. [PMID: 37079154 DOI: 10.1007/s10334-023-01084-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 03/12/2023] [Accepted: 03/22/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE The malignancy grades of parotid gland cancer (PGC) have been assessed for a decision of treatment policies. Therefore, we have investigated the feasibility of topology-based radiomic features for the prediction of parotid gland cancer (PGC) malignancy grade in magnetic resonance (MR) images. MATERIALS AND METHODS Two-dimensional T1- and T2-weighted MR images of 39 patients with PGC were selected for this study. Imaging properties of PGC can be quantified using the topology, which could be useful for assessing the number of the k-dimensional holes or heterogeneity in PGC regions using invariants of the Betti numbers. Radiomic signatures were constructed from 41,472 features obtained after a harmonization using an elastic net model. PGC patients were stratified using a logistic classification into low/intermediate- and high-grade malignancy groups. The training data were increased by four times to avoid the overfitting problem using a synthetic minority oversampling technique. The proposed approach was assessed using a 4-fold cross-validation test. RESULTS The highest accuracy of the proposed approach was 0.975 for the validation cases, whereas that of the conventional approach was 0.694. CONCLUSION This study indicated that topology-based radiomic features could be feasible for the noninvasive prediction of the malignancy grade of PGCs.
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Affiliation(s)
- Kojiro Ikushima
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Department of Radiological Technology, Yamaguchi University Hospital, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Hidetaka Arimura
- Division of Quantum Radiation Science, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Ryuji Yasumatsu
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Kindai University, 377-2, Onohigashi, Sayama, Osaka, 589-0014, Japan
| | - Hidemi Kamezawa
- Department of Radiological Technology, Faculty of Fukuoka Medical Technology, Teikyo University, 6-22 Misaki-machi, Omuta, Fukuoka, 836-8505, Japan
| | - Kenta Ninomiya
- Sanford Burnham Prebys Medical Discovery Institute, 10901 North Torrey Pines Road, La Jolla, CA, 92037, USA
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Kapoor A, Bakshi J, Panda NK, Sharma V, Bal A, Rampal M, Sedai R, Saharan D, Agarwal G, Gautamjit. Pathological Inconsistencies in Advanced Malignancies of the Parotid Gland. Indian J Otolaryngol Head Neck Surg 2023; 75:311-317. [PMID: 37275068 PMCID: PMC10235400 DOI: 10.1007/s12070-022-03160-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/05/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Archit Kapoor
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Jaimanti Bakshi
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Naresh K Panda
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Vikas Sharma
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Amanjeet Bal
- Department of Histopathology, PGIMER, Chandigarh, India
| | - Mayank Rampal
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Raghab Sedai
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Deepak Saharan
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Ganesh Agarwal
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
| | - Gautamjit
- Department of Otolaryngology & Head and Neck Surgery, PGIMER, 160012 Chandigarh, India
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Prognostic Factors of Pretreatment Magnetic Resonance Imaging for Predicting Clinical Outcome in Patients With Parotid Gland Cancer. J Comput Assist Tomogr 2023; 47:00004728-990000000-00105. [PMID: 36790873 DOI: 10.1097/rct.0000000000001408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE This study aimed to assess the utility of pretreatment magnetic resonance imaging (MRI) in predicting the clinical outcomes of patients with parotid gland cancer. METHODS A total of 43 patients with histopathologically confirmed primary parotid gland cancer, who underwent pretreatment MRI, were enrolled in this study. All images were retrospectively reviewed, and MRI features were evaluated as possible prognostic factors influencing the progression-free survival (PFS) using the Kaplan-Meier method and Cox proportional hazards regression model. Cox regression analysis was used to estimate the hazard ratios (HRs) with 95% confidence interval (95% CI) values. RESULTS Kaplan-Meier survival analysis showed that old age (>73 years, P < 0.01), large maximum tumor diameter (>33 mm, P < 0.01), low apparent diffusion coefficient value (≤1.29 ×10-3 mm2/s, P < 0.01), ill-defined margin (P < 0.01), skin invasion (P < 0.01), regional nodal metastasis (P < 0.01), heterogeneous enhancement (P < 0.05), and high signal intensity ratio on gadolinium-enhanced fat-suppressed T1-weighted images (>2.017, P < 0.05) were significant predictors of worse PFS. Cox proportional hazards regression analysis revealed that regional nodal metastasis (HR, 32.02; 95% CI, 6.42-159.84; P < 0.01) and maximum tumor diameter (HR, 1.04; 95% CI, 1.01-1.08; P < 0.05) were independent predictors of PFS. CONCLUSION Pretreatment MRI parameters could be prognostic factors of patients with parotid gland cancer. In particular, the maximum tumor diameter and regional nodal metastasis, which were closely associated with T and N classifications, were important prognostic factors in predicting the PFS.
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Taniuchi M, Terada T, Kawata R. Fine-Needle Aspiration Cytology for Parotid Tumors. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111897. [PMID: 36431032 PMCID: PMC9693155 DOI: 10.3390/life12111897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
Fine-needle aspiration (FNA) cytology is widely used in clinical practice as a simple and minimally invasive test for parotid tumors that allows for preoperative estimation of benignancy and malignancy, histological type, and malignancy grade and can be performed on an outpatient basis. In recent years, cell blocks prepared with core needle biopsy (CNB) and liquid-based cytology (LBC) have increased the reliability of immunostaining and molecular biological testing, leading to improved diagnostic accuracy. In 2018, the Milan System for Reporting Salivary Gland Cytology was introduced, but it does not include malignancy grade or histological type, so we proposed the Osaka Medical College classification as a more clinically based cell classification that includes both types of information, and we have reported on its usefulness. This review gives an overview of the history and use of FNA and describes CNB and LBC and the two classification systems.
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Kanetake H, Inaka Y, Kinoshita I, Ayani Y, Ozaki A, Omura S, Higashino M, Terada T, Haginomori SI, Kawata R. Characteristics and Outcomes of Parotid Gland Tumors in Adolescents. EAR, NOSE & THROAT JOURNAL 2021:1455613211064013. [PMID: 34961349 DOI: 10.1177/01455613211064013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Parotid tumors are rare neoplasms in adults but are exceedingly infrequent in adolescents. We aimed to determine the clinical characteristics and outcomes of parotid tumors in adolescents under 20 years old. METHODS Between 1999 and 2020, 979 cases of benign parotid tumors and 236 cases of malignant parotid tumors were treated surgically in our department. Of these, 12 benign cases (1.2%) and 9 malignant cases (3.8%) were in adolescents. There were no benign or malignant cases for those aged under 10 years. RESULTS Regarding the histological type, all benign tumors were pleomorphic adenomas. About half of malignant tumors were mucoepidermoid carcinomas, and excluding one high-grade case, the grade of malignancy was all low/intermediate. The accuracy of fine-needle aspiration cytology among adolescents showed no significant difference with that of adults. In contrast to adults, adolescent benign tumor cases showed a markedly high rate of pleomorphic adenomas and no postoperative facial nerve palsy. Malignant tumors in adolescents had a different trend than adults; low/intermediate-grade malignancies were common and thus few symptoms/signs of malignancy could be observed. As well, the accuracy of fine-needle aspiration cytology was poor. All cases had a good prognosis and are disease-free survival. CONCLUSION Parotid tumors in adolescents are rare but have several characteristics that are distinct from adults. As long-term observation is required posttreatment in adolescent patients, recurrence in benign pleomorphic adenomas and poor long-term prognosis in malignant tumors, especially for those with low/intermediate-grade malignancy, are more likely to be observed.
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Affiliation(s)
- Hirofumi Kanetake
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuko Inaka
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Ichita Kinoshita
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yusuke Ayani
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Akiko Ozaki
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Shuji Omura
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Masaaki Higashino
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Shin-Ichi Haginomori
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology-Head and Neck Surgery, 2013010Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Choy KCC, Bundele MM, Fu EW, Li H, Gan JYJ, Rao NCL, Lim MY. Risk stratification of parotid neoplasms based on intraoperative frozen section and preoperative fine needle aspiration cytology. Eur Arch Otorhinolaryngol 2021; 279:2117-2131. [PMID: 34342679 DOI: 10.1007/s00405-021-07015-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aims to determine the relationship of frozen section (FS) to final histology and determine how incorporating FS may change preoperative malignancy risk estimates based on preoperative fine needle aspiration cytology (FNAC). The secondary aim is to determine if FS is useful in influencing intraoperative decision-making. METHODS Retrospective review of 426 intraoperative FS for parotidectomies performed for primary parotid lesions. RESULTS Risk of malignancy with a benign FS was 2.5%, with indeterminate 36.1%, and with malignant 100%. Incorporating FS to fine needle aspiration for cytology helped to stratify malignancy risk especially in the Milan categories of atypia of undetermined significance, neoplasm of uncertain malignant potential and non-diagnostic categories, where a malignant FS increased malignancy risk significantly. FS was only able to identify 11% of high-risk histological subtypes for which a neck dissection would be recommended. CONCLUSIONS FS may be used to stratify malignancy risk intraoperatively but has limited utility in clinical decision-making to perform a neck dissection and more extensive parotid resection in high-risk histological subtypes.
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Affiliation(s)
- Kevin C C Choy
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Manish M Bundele
- Department of Pathology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ernest W Fu
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Hao Li
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Jereme Y J Gan
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Nandini C L Rao
- Department of Pathology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ming Yann Lim
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore
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Geiger JL, Ismaila N, Beadle B, Caudell JJ, Chau N, Deschler D, Glastonbury C, Kaufman M, Lamarre E, Lau HY, Licitra L, Moore MG, Rodriguez C, Roshal A, Seethala R, Swiecicki P, Ha P. Management of Salivary Gland Malignancy: ASCO Guideline. J Clin Oncol 2021; 39:1909-1941. [PMID: 33900808 DOI: 10.1200/jco.21.00449] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations for practicing physicians and other healthcare providers on the management of salivary gland malignancy. METHODS ASCO convened an Expert Panel of medical oncology, surgical oncology, radiation oncology, neuroradiology, pathology, and patient advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2020. Outcomes of interest included survival, diagnostic accuracy, disease recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 293 relevant studies to inform the evidence base for this guideline. Six main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, and follow-up evaluations. RECOMMENDATIONS When possible, evidence-based recommendations were developed to address the diagnosis and appropriate preoperative evaluations for patients with a salivary gland malignancy, therapeutic procedures, and appropriate treatment options in various salivary gland histologies.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Marnie Kaufman
- Adenoid Cystic Carcinoma Research Foundation, Needham, MA
| | | | | | - Lisa Licitra
- Istituto Nazionale Tumori, Milan, Italy.,University of Milan, Milan, Italy
| | | | | | | | | | | | - Patrick Ha
- University of California San Francisco, San Francisco, CA
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Terada T, Kawata R, Higashino M, Kurisu Y, Kuwabara H, Hirose Y. Basal cell adenocarcinoma of the parotid gland: Comparison with basal cell adenoma for preoperative diagnosis. Auris Nasus Larynx 2020; 48:310-316. [PMID: 32950324 DOI: 10.1016/j.anl.2020.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/13/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To summarize the diagnosis and treatment outcomes of basal cell adenocarcinoma (BCAC) of the parotid gland, a rare low-grade malignancy, at a single institution, and to investigate the treatment approach for this rare malignancy. METHODS We conducted a retrospective analysis of 9 patients with BCAC during 20 years from September 1999 to December 2019. Forty-five patients with basal cell adenoma (BCA), who were treated during the same time period, were used for comparison. The clinical characteristics of BCAC, diagnostic imaging, the usefulness of fine-needle aspiration cytology (FNAC) and frozen section biopsy (FSB), histological assessment of malignancy, and treatment outcomes were investigated. RESULTS There were no marked differences in sex, age, tumor diameter, or tumor location between BCAC and BCA cases. Among the 9 patients with BCAC, one patient was noted with pain/tenderness, and two patients were observed with adhesion to the surrounding tissues. Only one patient was diagnosed as malignant based on MRI/US. FNAC for BCAC was suspicious for malignancy in 6 of the 9 cases, which included one patient with the correct grade of malignancy, one patient with malignancy only, and 4 patients suspicious for malignancy. FSB was suspicious for malignancy in 8 of the 9 cases. Malignancy grade was determined based on infiltration to the surrounding tissues and expression of Ki-67, p53, and bcl-2. One patient with infiltration to the surrounding tissue was diagnosed as intermediate-grade malignancy, while the remaining 8 patients were diagnosed as low-grade malignancy. The BCAC cases included 7 patients with T2 and 2 patients with T1. Conservative resection was performed for all patients, and all cases are surviving cancer-free. CONCLUSION The malignancy of BCAC can be suspected before surgery based on symptoms/signs, diagnostic imaging, and FNAC. FSB enables the diagnosis of not only malignancy but also the grade of malignancy, which may help determine the appropriate surgical resection. Although all 9 patients with BCAC are surviving free from cancer, a long-term follow-up is warranted.
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Affiliation(s)
- Tetsuya Terada
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki 569-8686, Osaka, Japan.
| | - Ryo Kawata
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki 569-8686, Osaka, Japan
| | - Masaaki Higashino
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki 569-8686, Osaka, Japan
| | - Yoshitaka Kurisu
- Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Hiroko Kuwabara
- Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Yoshinobu Hirose
- Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan
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Challenges with preoperative diagnosis of low/intermediate-grade carcinoma of the parotid gland: single-center study of 112 patients. Eur Arch Otorhinolaryngol 2020; 277:2031-2039. [PMID: 32166415 DOI: 10.1007/s00405-020-05871-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The malignancy of parotid carcinoma varies, and accurate preoperative assessment of malignancy is important for selecting the appropriate treatment. However, the preoperative diagnosis of low/intermediate-grade carcinoma is difficult, and surgery may sometimes be performed without any prior knowledge of malignancy. METHODS The results of fine-needle aspiration cytology (FNA), imaging studies (MRI and US), physical examination, and frozen section biopsy (FSB) were evaluated in 112 patients with low/intermediate-grade parotid carcinoma. RESULTS The result of FNA was benign/inadequate specimen in 44.6% of the patients. In addition, the tumor was diagnosed as benign by MRI/US in 21.4% of the patients and 37.5% had no symptoms/signs of malignancy on physical examination. The rate of misdiagnosis as benign decreased when FNA was combined with imaging and physical findings. However, malignancy could not be diagnosed by FNA and FSB in 12.5% of the patients who were only found to have malignant tumors by the final pathological examination. CONCLUSION FNA shows a high misdiagnosis rate of malignancy in patients with low/intermediate-grade cancer. Therefore, it is necessary to carefully evaluate the findings of imaging studies and physical examination, and FSB should be conducted if such findings suggest the possibility of malignancy.
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Fine needle aspiration cytology for parotid neoplasms: risk of malignancy through inconclusive results and lower grade tumors. Eur Arch Otorhinolaryngol 2019; 277:841-851. [DOI: 10.1007/s00405-019-05733-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/11/2019] [Indexed: 01/16/2023]
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Bouatay R, Nasr RB, Moussa A, El Korbi A, Harrathi K, Koubaa J. [The importance of fine needle aspiration biopsy in the diagnosis of parotid tumors]. Pan Afr Med J 2019; 33:65. [PMID: 31448027 PMCID: PMC6689855 DOI: 10.11604/pamj.2019.33.65.18259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/16/2019] [Indexed: 11/18/2022] Open
Abstract
This study aimed to determine the diagnostic value of fine needle aspiration biopsy (FNAB) and of its contribution to the management of parotid tumors. We conducted a retrospective study of 47 patients who had undergone parotidectomy as well as preoperative fine needle aspiration biopsy. The study highlighted that eighty one percent of patients had a benign tumor while 19% of patients had a malignant tumor. The sensitivity and specificity of FNAB were 78% and 92% respectively. Parotid tumors were correctly classified as malignant or benign in 89% of cases, overall accuracy was 64.4%. FNAB is a reliable examination providing preoperative informations about the treatment plan and the postoperative course.
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Affiliation(s)
- Rachida Bouatay
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Rim Ben Nasr
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Adnène Moussa
- Service d'Anatomie Pathologique de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Amel El Korbi
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Khaled Harrathi
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Jamel Koubaa
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
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14
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Grasl S, Kadletz L, Janik S, Riedl A, Erlacher B, Formanek M, Grasl MC, Erovic BM. Fine-needle aspiration cytology and intraoperative frozen section in parotid gland tumour surgery: A retrospective multicenter analysis of 417 cases. Clin Otolaryngol 2019; 44:461-465. [PMID: 30779480 DOI: 10.1111/coa.13314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/26/2018] [Accepted: 02/03/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Stefan Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Lorenz Kadletz
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Agnes Riedl
- Department of Otorhinolaryngology and Phonetics, Hospital of St. John of God, Vienna, Austria.,Department of Laryngology, Sigmund Freud Private University, Medical School, Vienna, Austria
| | - Birgit Erlacher
- Department of Otorhinolaryngology and Phonetics, Hospital of St. John of God, Vienna, Austria.,Department of Laryngology, Sigmund Freud Private University, Medical School, Vienna, Austria
| | - Michael Formanek
- Department of Otorhinolaryngology and Phonetics, Hospital of St. John of God, Vienna, Austria.,Department of Laryngology, Sigmund Freud Private University, Medical School, Vienna, Austria
| | - Matthaeus C Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria
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15
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Jinnin T, Kawata R, Higashino M, Nishikawa S, Terada T, Haginomori SI. Patterns of lymph node metastasis and the management of neck dissection for parotid carcinomas: a single-institute experience. Int J Clin Oncol 2019; 24:624-631. [DOI: 10.1007/s10147-019-01411-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 01/31/2019] [Indexed: 11/28/2022]
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16
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Bilateral Synchronous Mucoepidermoid Carcinoma of the Parotid Gland. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2018; 52:145-148. [PMID: 32595390 PMCID: PMC7315060 DOI: 10.14744/semb.2017.74936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/17/2017] [Indexed: 11/20/2022]
Abstract
Mucoepidermoid carcinoma is the most common malignant tumor of the parotid; however, its synchronous occurrence in both of the parotid glands is extremely rare. Herein, we presented a case of 53-year-old man with bilateral synchronous mucoepidermoid carcinoma of the parotid gland treated with surgery. The patient mainly complained of a painless mass in the left parotid gland. A mass located in the right parotid gland was incidentally detected by imaging. Based on cytopathology, left total parotidectomy was performed while preserving the facial nerve with ipsilateral neck dissection, and 5 weeks later, right superficial parotidectomy was performed. At the 3-year follow-up, there was no recurrence in the parotid regions and the neck. A detailed examination for parotid masses is suggested for identifying possible occult synchronous tumors in the contralateral side or in other salivary glands. A close follow-up is also recommended for the risk of future occurrence of metachronous tumors.
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17
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A clinicopathological study of parotid carcinoma: 18-year review of 171 patients at a single institution. Int J Clin Oncol 2018; 23:615-624. [PMID: 29564569 PMCID: PMC6097105 DOI: 10.1007/s10147-018-1266-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/14/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study investigated the clinical outcomes of patients with parotid carcinoma at a single institution during an 18-year period, with the focus on diagnosis, treatment, and survival. METHODS The subjects were 171 patients with parotid carcinoma treated at our department during the 18-year period from September 1999 to August 2017. There were 19 patients in stage I, 65 patients in stage II, 22 patients in stage III, and 65 patients in stage IV. The symptoms, preoperative diagnosis, node metastasis, survival rate, prognostic factors, and immunohistological findings were investigated. RESULTS Preoperative diagnosis of the histological grade by fine-needle aspiration cytology was only possible in 34% of the patients, while the histological grade was correctly determined by frozen section biopsy in 72%. The overall frequency of lymph node metastasis was 29%, with 59% in patients with high-grade carcinoma and only 6% in those with low-/intermediate-grade tumors. The disease-specific 5-year survival rate was 100% for patients in stage I, 95.2% in stage II, 70.4% in stage III, and 45.1% in stage IV. Multivariate analysis showed that the pathological grade was the most important prognostic factor. Immunohistological investigation showed patients with HER-2 or androgen receptor-positive tumors had a significantly worse prognosis. CONCLUSIONS Although a high-grade tumor is the most important prognostic factor, preoperative diagnosis of the grade was not always accurate. Since advanced cancer has a poor prognosis with a limited response to surgery and radiation therapy, development of new treatment strategies, such as molecular-targeting therapies directed against HER-2 and AR, is required.
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18
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Zhang X, Zeng X, Lan X, Huang J, Luo K, Tian K, Wu X, Xiao F, Li S. Reoperation following the use of non-standardized procedures for malignant parotid tumors. Oncol Lett 2017; 14:6701-6707. [PMID: 29163697 DOI: 10.3892/ol.2017.7020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 07/27/2017] [Indexed: 11/06/2022] Open
Abstract
Non-standardized or conservative procedures are employed when parotid tumors involving the facial nerve or parotid carcinoma are misdiagnosed as benign parotid tumors prior to or during surgery. Remedial measures are usually required when the pathological diagnosis of a malignant parotid tumor is confirmed following surgery. The aim of the present study was to systematically evaluate reoperation subsequent to treatment with non-standardized procedures for malignant parotid tumors, and to explore the preoperative diagnoses, the primary procedure selection and the necessity of reoperation following non-standardized procedures in malignant parotid tumors. A total of 30 patients who met the inclusion criteria, were diagnosed with a malignant parotid tumor and underwent reoperation following the use of a non-standardized procedure were included in the present study. Surgical conditions and clinical data were analyzed. Among the patients with a malignant parotid tumor who underwent reoperation subsequent to a non-standardized procedure, the incidence of residual tumor, as confirmed by pathological examination, was 63.3% (19/30). The intact facial nerve preservation rate was 83.3% (25/30), the facial nerve branch resection rate was 6.7% (2/30), the facial partial nerve resection rate was 6.7% (2/30) and the facial nerve resection rate was 3.3% (1/30). In total, 3 patients underwent facial nerve reconstruction, 3 patients underwent a local flap repair of skin defects in the parotid region and 3 patients underwent pectoralis major muscle flap repair. The current findings indicate that the qualitative diagnosis of malignant parotid tumors prior to surgery is difficult, there is a high incidence of residual tumor following non-standardized procedures, and that reoperation in a timely manner is required in such cases.
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Affiliation(s)
- Xiangmin Zhang
- Department of Head and Neck, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Xiangfu Zeng
- Department of General Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China
| | - Xiaolin Lan
- Department of Head and Neck, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Jing Huang
- Ganzhou Institute of Cancer Research, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Keqing Luo
- Department of Head and Neck, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Keqiang Tian
- Department of Head and Neck, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Xiuhong Wu
- Department of Radiation Oncology, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Fufu Xiao
- Department of Head and Neck, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
| | - Shaojin Li
- Ganzhou Institute of Cancer Research, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi 341000, P.R. China
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