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Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter
Médarine Roch1, Olivier Mauvais2, Sebastien Vergez3
1ENT Department, Regional University Hospital of Nancy, Nancy, France.
The Annals of Otology, Rhinology, and Laryngology
|September 9, 2021
Summary
Systematic revision surgery after parotidectomy for malignant tumors is often needed for close margins. Tumor residue was found in 43.5% of cases, suggesting revision is crucial for high-grade tumors or positive lymph nodes.
Area of Science:
- Head and Neck Surgery
- Surgical Oncology
- Otolaryngology
Background:
- Close margins are common after parotidectomy for malignant tumors.
- The necessity of prophylactic revision surgery for these cases remains debated due to risks like facial palsy and unclear oncological benefits.
Purpose of the Study:
- To evaluate the rate of tumor residue and identify risk factors in patients undergoing systematic revision surgery after parotidectomy for malignant tumors with close margins.
Main Methods:
- A multicentric retrospective study was conducted.
- Patients who underwent systematic revision surgery for close margins after parotidectomy for malignant tumors were included.
- Tumor residue rates and associated risk factors were analyzed.
Main Results:
- Tumor residue was detected in 43.5% of 23 cases.
- No tumor residue was found in cases with initial complete excision and supra-millimetric margins.
- Invaded lymph nodes were identified in 6 cases, primarily in high-grade tumors.
Conclusions:
- Systematic revision surgery appears mandatory for infra-millimetric margins, high-grade tumors, or positive lymph nodes.
- Further research is needed to determine if revision can be omitted for T1-T2/N0 low-grade tumors with close but complete initial excision.
