J Neurol Surg B Skull Base 2018; 79(S 01): S1-S188
DOI: 10.1055/s-0038-1633511
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

Clinical and Pathological Parameters Prognostic in Temporal Bone Resection for Locally Advanced Malignant Parotid Tumor

Livia S. Dechen
1   A.C.Camargo Center, Sao Paulo, Brazil
,
Ronaldo N. Toledo
1   A.C.Camargo Center, Sao Paulo, Brazil
,
Jose Ricardo G. Testa
1   A.C.Camargo Center, Sao Paulo, Brazil
,
Genival B. Carvalho
1   A.C.Camargo Center, Sao Paulo, Brazil
,
Luiz P. Kowalski
1   A.C.Camargo Center, Sao Paulo, Brazil
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Publikationsdatum:
02. Februar 2018 (online)

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Salivary gland cancers are rare, corresponding for less than 3% of all head and neck cancers. Approximately 70% of salivary cancers occur in the parotid gland. Surgery is the mainstay treatment for malignant parotid tumors and should be pursued when negative surgical margins can be achieved.

Tumors originated in the parotid can grow into the external ear canal or into the temporal bone. An adequate surgical resection may require the removal of the adjacent temporal bone.

We performed a retrospective, single-institution review of extended parotidectomy with temporal bone resection in 23 patients with malignant parotid tumor from May 2000 to February 2017.

Twelve (52,18%) patients were male and eleven (47,82%) were female. The average age of patients was 49.4 years (23–88). Fourteen (60.9%) patients underwent salvage surgery for recurrent malign tumor and 9 patients (39.1%) for primary surgical treatment; 18 (78.2%) patients received adjuvant external radiotherapy and 10 (43,5%) patients received chemotherapy.

The histopathological etiologies were heterogeneous: 7 (30.4%) adenoid cystic carcinoma, 7 (30.4%) mucoepidermoid carcinoma, 2 (8.7%) acinic cell carcinoma, 2 (8.7%) carcinoma ex-pleomorphic adenoma, 1 (4.3%) adenocarcinoma, 1 (4.3%) carcinoma ex-mixed tumor, 1 (4.3%) undifferentiated carcinoma, and 1 (4.3%) salivary duct carcinoma.

At the time of diagnosis, 19 (82.6%) patients had staging T4a and 4 patients (17.4%) had T4b. Histopathologic diagnoses of metastatic neck lymph nodes were made in 4 (17.4%) patients. There was no case of distant metastasis.

All patients underwent temporal bone resections. Eighteen (78.2%) had lateral temporal resection and four patients (17.4%) had subtotal resection and 1 (4.3%) patient had total temporal bone resection including internal carotid artery. In 12 (52.2%) patients, a neck dissection was performed.

Five-year overall survival was 36% and free-disease survival at 5 years was 29.6%.