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Liu L, Xiang Y, Shui C, Li C, Xiong L, Hu J, Ai H, Zhou Y, Jiang J, Cai Y. Long-term follow-up and prognostic analysis of parotid tumors in children and adolescents. Laryngoscope Investig Otolaryngol 2024; 9:e1275. [PMID: 38835331 PMCID: PMC11149764 DOI: 10.1002/lio2.1275] [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: 12/17/2023] [Revised: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives The objective of this study is to summarize the clinical characteristics, treatment, and prognosis of parotid tumors in children and adolescents. Methods Fifty-three children and adolescents diagnosed with parotid gland tumors were included. Survival was evaluated using the Kaplan-Meier method. Log-rank test and multivariate analysis were used to analyze the association between clinical factors and recurrence. Results Of the 53 patients, 30 cases were benign and 23 cases were malignant. All patients underwent surgery. Patients with malignant tumors with high-risk factors received radiotherapy or chemotherapy. The median follow-up time was 61 months. Of these, 1 patient with benign tumor and 5 patients with malignant tumors recurred. Of the patients with malignant tumors, 2 developed distant metastases and 2 died. The 5-year overall survival (OS) and 5-year locoregional recurrence-free survival (LRFS) rates for benign tumors were 100.0% and 92.9%, respectively, whereas the 5-year OS and 5-year LRFS rates for malignant tumors were 94.4% and 72.5%, respectively. The log-rank univariate test showed that tumor size >3.5 cm (p = .056), distant metastasis (p = .056), and stage III and IV (p = .032) were associated with recurrence. However, multivariate analysis did not show the above factors to be independent prognostic factors for LRFS. Conclusion Surgery for benign tumors depends on the location and size. Surgery for malignant parotid tumors depends mainly on the stage, grade, pathological type, and recurrence. Prophylactic lymph node dissection is required for high-grade tumors. Radiotherapy or chemotherapy for children needs more research. Both benign and malignant tumors have high survival rates after active treatment. Level of evidence Level 2.
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Affiliation(s)
- Lei Liu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Yuqing Xiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Chunyan Shui
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Lujing Xiong
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Jinchuan Hu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Hao Ai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Yuqiu Zhou
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Jian Jiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Yongcong Cai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
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Younes A, Taher MF, Sidhom I, Zekri W, Zaky I, Elfendy H, Taher AN, Khedr SA, Gamal R, Ahmed G. Parotid gland masses: outcomes in the pediatric age group. J Egypt Natl Canc Inst 2023; 35:2. [PMID: 36740629 DOI: 10.1186/s43046-023-00161-8] [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: 08/01/2022] [Accepted: 01/12/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Childhood parotid neoplasms appear to have different characteristics from adults. This point, in addition to the rarity of these tumors, reflects the challenges faced in diagnosing and treating parotid neoplasms in children. PATIENTS AND METHODS This retrospective study included all children who presented to the Children's Cancer Hospital Egypt (CCHE, 57357) with parotid masses from January 2008 to December 2020. RESULTS Twenty-one patients were included. Malignant neoplasms were found in 12 (57.1%) of which mucoepidermoid carcinoma was the most common. Benign neoplasms were found in 6 (28.6%) all of them were pleomorphic adenoma, and non-neoplastic lesions were found in 3 (14.3%). Superficial, deep, or total parotidectomy was performed according to the involved lobes. The facial nerve was sacrificed in three cases because of frank invasion by the tumor. Neck dissection was considered in clinically positive lymph nodes and/or T3/4 masses. Complications occurred in 7 (33.3%) all were of the malignant cases. Adjuvant radiotherapy was restricted to high-risk cases (7 cases). Recurrence occurred in two cases, and one patient died of distant metastasis. Fine needle aspiration cytology (FNAC) showed 88.9% sensitivity and 100% specificity for diagnosing malignant neoplasms. The correlation of radiological and pathological staging was fair (66.74% for overall staging). CONCLUSIONS Parotidectomy is the backbone treatment for benign and malignant pediatric parotid tumors. Neck nodal dissection should be considered after preoperative FNAC of suspicious nodes. Adjuvant radiotherapy is considered only in high-risk tumors. Preoperative FNAC of parotid masses and clinically suspicious lymph nodes is highly recommended.
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Affiliation(s)
- Alaa Younes
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.,Department of Surgical Oncology, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Mohammad Fouad Taher
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt. .,Department of Surgical Oncology, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt.
| | - Iman Sidhom
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.,Department of Pediatric Oncology, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Wael Zekri
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.,Department of Pediatric Oncology, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Iman Zaky
- Department of Radiodiagnosis, National Cancer Institute, Cairo University, Cairo, Egypt.,Department of Radiodiagnosis, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Habiba Elfendy
- Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt.,Department of Pathology, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Azza Niazy Taher
- Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.,Department of Radiation Oncology, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Suzan Adlan Khedr
- Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Rana Gamal
- Department of Clinical Research, Children Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt
| | - Gehad Ahmed
- Department of General Surgery, Faculty of Medicine, Helwan University, Helwan, Egypt
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Tangjaturonrasme N, Samuckkeethum W, Klibngern H, Ratanaprasert N, Naruekon J, Jantharapattana K. Pediatric parotidectomy outcomes: A 14-year multicenter study. Laryngoscope Investig Otolaryngol 2022; 7:1875-1880. [PMID: 36544925 PMCID: PMC9764785 DOI: 10.1002/lio2.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022] Open
Abstract
Objectives Parotidectomy increases childhood challenges. This study aimed to determine the clinical profiles, investigations, and outcomes of pediatric patients who had undergone parotidectomy. Methods A multicenter retrospective review of parotidectomy in pediatric patients between 2007 and 2020. Results In 108 parotidectomies, the final diagnoses were benign (47.22%), malignant (36.11%), and non-neoplastic (16.67%). The incidence of facial palsy was 37.03%, which was significantly lower in the superficial group than that in the total parotidectomy group (p = .021). The incidence of facial nerve palsy was significantly higher in the malignancy group than that in the benign group (p = .035). Magnetic resonance imaging (MRI) detected malignancy with 92.8% overall accuracy, 83.3% sensitivity, and 100% specificity. The sensitivity and specificity of fine-needle aspiration (FNA) were 54.2% and 92.7%, respectively. Conclusions Parotidectomy is commonly performed for benign and non-neoplastic diseases in pediatric patients. Facial nerve palsy is significantly associated with malignant tumors and total parotidectomy. MRI is the most accurate imaging modality for diagnosing malignant lesions. FNA exhibits moderate agreement with the final pathology. Level of Evidence Level IV.
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Affiliation(s)
| | - Wisarut Samuckkeethum
- Department of Otolaryngology, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Hanpon Klibngern
- Department of Otolaryngology, Faculty of MedicineChiang Mai University HospitalChiang MaiThailand
| | - Narin Ratanaprasert
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jakkree Naruekon
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Kitti Jantharapattana
- Department of Otolaryngology Head and Neck Surgery, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
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