Clinicopathologic and Surgical Study of Pleomorphic Adenoma of the Parotid Gland: Analysis of Risk Factors for Recurrence and Facial Nerve Dysfunction
| Autor: | Paloma Lequerica-Fernández, Carlos A. Espinosa, Lucas de Villalaín, Juan Carlos de Vicente, Álvaro Fernández-Valle |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adenoma Adolescent Enucleation Adenoma Pleomorphic Pleomorphic adenoma 03 medical and health sciences symbols.namesake 0302 clinical medicine Risk Factors medicine Humans 030223 otorhinolaryngology Fisher's exact test Aged Retrospective Studies Aged 80 and over business.industry Age Factors Margins of Excision Retrospective cohort study Middle Aged medicine.disease Facial nerve Parotid gland Surgery Parotid Neoplasms Facial Nerve medicine.anatomical_structure Otorhinolaryngology Superficial Parotidectomy 030220 oncology & carcinogenesis symbols Female Oral Surgery Neoplasm Recurrence Local business |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 76(2) |
| ISSN: | 1531-5053 |
| Popis: | To determine whether clinicopathologic or surgical features are risk factors for recurrence and facial nerve dysfunction in pleomorphic adenoma (PA) of the parotid gland.The records of 198 patients surgically treated for a PA of the parotid gland from 1999 through 2013 were retrospectively reviewed to identify patients who developed a tumor recurrence. The Fisher exact test and Mann-Whitney U test were used to analyze patient characteristics between recurrent and non-recurrent PAs. Logistic regression was used to determine the risks of recurrence and facial nerve dysfunction.Twenty-three patients (11.6%) developed a recurrence. Patients with tumor recurrence were notably younger than patients without recurrence. Of the 14 patients who underwent enucleation, 11 (78.6%) developed residual disease, as did 10 of 165 patients (6%) managed by a superficial parotidectomy (P .0005). Furthermore, the risk of residual disease was 9.3 to 21.6 times higher in patients who underwent enucleation than in those who underwent a total or superficial parotidectomy. For tumor histology, recurrence was observed in 3 (15.8%) of the 19 cellular types, 18 (11.5%) of 157 classic cases, and 1 (4.8%) of 21 myxoid cases (P = .5). The risk of recurrence with positive resection margins was 49 times higher than with negative margins (P = .001).Young age, enucleation, and positive margins are risk factors for residual pleomorphic adenoma, and surgical technique and histomorphologic features are associated with increased facial nerve dysfunction. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|