Extracapsular dissection for clinically benign parotid lumps: 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.ukIssue Date
2003-11-03
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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.Citation
Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise. 2003, 89 (9):1610-3 Br. J. CancerJournal
British Journal of CancerDOI
10.1038/sj.bjc.6601281PubMed ID
14583757Type
ArticleLanguage
enISSN
0007-0920ae974a485f413a2113503eed53cd6c53
10.1038/sj.bjc.6601281
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