Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise.

2.50
Hdl Handle:
http://hdl.handle.net/10541/78806
Title:
Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise.
Authors:
McGurk, Mark; Thomas, B L; Renehan, Andrew G
Abstract:
Previous studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tumour masquerades as a clinically benign lump, this approach may be inappropriate. This study addressed this question by analysing the outcome of 821 consecutive patients with parotid tumours treated at one centre over 40 years and with a median 12 (range 5-30) years follow-up. Tumours were classified as 'simple' (discrete, mobile, < 4 cm: n=662) and 'complex' (deep, fixed, facial nerve palsy, > or =4 cm: n=159). Among the 'simple' or clinically benign tumours, 503 patients underwent ECD; 159 patients underwent SP. In all, 32 (5%) clinically benign cases were subsequently revealed as malignant histologies (ECD, 12; SP, 20). For each group, 5- and 10-year cancer-specific survival rates were 100 and 98%, respectively. There were no differences in recurrence rates when subanalysed by surgical groups, but ECD was associated with significantly reduced morbidity (P < 0.001). This study demonstrates that ECD is a viable alternative to superficial parotidectomy for the majority of parotid tumours, associated with reduced morbidity without oncological compromise.
Affiliation:
Salivary Gland Service, Department of Oral and Maxillofacial Surgery, Floor 23 Guy's Tower, Guy's Hospital, London Bridge, London SE1 9RT, UK. mark.mcgurk@kcl.ac.uk
Citation:
Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise. 2003, 89 (9):1610-3 Br. J. Cancer
Journal:
British Journal of Cancer
Issue Date:
3-Nov-2003
URI:
http://hdl.handle.net/10541/78806
DOI:
10.1038/sj.bjc.6601281
PubMed ID:
14583757
Type:
Article
Language:
en
ISSN:
0007-0920
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMcGurk, Mark-
dc.contributor.authorThomas, B L-
dc.contributor.authorRenehan, Andrew G-
dc.date.accessioned2009-08-27T10:01:23Z-
dc.date.available2009-08-27T10:01:23Z-
dc.date.issued2003-11-03-
dc.identifier.citationExtracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise. 2003, 89 (9):1610-3 Br. J. Canceren
dc.identifier.issn0007-0920-
dc.identifier.pmid14583757-
dc.identifier.doi10.1038/sj.bjc.6601281-
dc.identifier.urihttp://hdl.handle.net/10541/78806-
dc.description.abstractPrevious studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tumour masquerades as a clinically benign lump, this approach may be inappropriate. This study addressed this question by analysing the outcome of 821 consecutive patients with parotid tumours treated at one centre over 40 years and with a median 12 (range 5-30) years follow-up. Tumours were classified as 'simple' (discrete, mobile, < 4 cm: n=662) and 'complex' (deep, fixed, facial nerve palsy, > or =4 cm: n=159). Among the 'simple' or clinically benign tumours, 503 patients underwent ECD; 159 patients underwent SP. In all, 32 (5%) clinically benign cases were subsequently revealed as malignant histologies (ECD, 12; SP, 20). For each group, 5- and 10-year cancer-specific survival rates were 100 and 98%, respectively. There were no differences in recurrence rates when subanalysed by surgical groups, but ECD was associated with significantly reduced morbidity (P < 0.001). This study demonstrates that ECD is a viable alternative to superficial parotidectomy for the majority of parotid tumours, associated with reduced morbidity without oncological compromise.en
dc.language.isoenen
dc.subjectCancer Recurrenceen
dc.subjectParotid Canceren
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshParotid Neoplasms-
dc.subject.meshSurgical Procedures, Operative-
dc.subject.meshSurvival Rate-
dc.titleExtracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise.en
dc.typeArticleen
dc.contributor.departmentSalivary Gland Service, Department of Oral and Maxillofacial Surgery, Floor 23 Guy's Tower, Guy's Hospital, London Bridge, London SE1 9RT, UK. mark.mcgurk@kcl.ac.uken
dc.identifier.journalBritish Journal of Canceren

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