MALIGNANT EPITHELIAL PAROTID-GLAND TUMORS - ANALYSIS AND RESULTS IN 65 PREVIOUSLY UNTREATED PATIENTS

Background Optimal management of malignant epithelial parotid tumours requires knowledge of the available therapeutic modalities and the dif ferent biological characteristics. The aim of the study was to review the characteristics of patients at presentation, histological classifi cation, disease-free and overall survival rates, and the results of th e applied treatment policy regarding the facial nerve and neck. Method s Between 1974 and 1995 a total of 65 patients was treated with curati ve intent for a previously untreated malignant epithelial parotid glan d tumour. All patients underwent some type of parotidectomy, 20 of who m had an en bloc radical neck dissection. In selected cases the facial nerve or its branches were peeled off the tumour thus violating the o bjective of tumour-free margins and relying heavily on the efficacy of postoperative radiotherapy. In total 51 patients received postoperati ve radiotherapy. None of the patients was lost to follow-up. Results T here were 12 locoregional failures (18 per cent). In only one of these 12 patients was salvage therapy successful; the remaining 11 patients died from the tumour. All but one of the eight patients with distant metastasis only died from the tumour. The estimated 5- and 10-year dis ease-free rates were 68 and 59 per cent respectively. The correspondin g survival rates were 75 per cent and 67 per cent. A significant relat ionship could be observed between tumour stage and survival. The prese nce of lymph node metastases proved to be the strongest single prognos tic factor. Conclusion In selected cases a conservative approach towar ds the facial nerve is justified.