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Total Parotidectomy Versus Less-Than-Total Parotidectomy for Early-Stage Low Grade Parotid Cancer: A Systematic
Nayeon Choi1, Hye Ran Lee2, Jungirl Seok3
1Department of Otolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Korea.
Laryngoscope Investigative Otolaryngology
|August 7, 2026
Summary
Less-than-total parotidectomy (LTT) offers comparable oncologic outcomes to total parotidectomy (TP) for low-grade parotid tumors. This approach may provide superior functional results, supporting individualized surgical strategies.
Area of Science:
- Head and Neck Surgery
- Surgical Oncology
- Otolaryngology
Background:
- Total parotidectomy (TP) is standard for parotid malignancies, aiming for complete tumor clearance and lymph node removal.
- Less-than-total parotidectomy (LTT) is an alternative that may achieve similar oncologic control with better functional outcomes.
Purpose of the Study:
- To compare oncologic and functional outcomes between LTT and TP in patients with T1-2 low-grade parotid malignancies.
- To evaluate the efficacy of LTT versus TP through a systematic review and meta-analysis.
Main Methods:
- Systematic literature search conducted following PRISMA guidelines.
- Included four retrospective cohort studies comparing LTT and TP for T1-2 low-grade parotid cancer.
- Analyzed overall survival (OS) and recurrence-free survival (RFS) using random-effects models and assessed heterogeneity.
Main Results:
- No significant difference in OS between LTT and TP was found across three studies.
- Recurrence-free survival (RFS) was comparable between LTT and TP in four studies.
- Negligible statistical heterogeneity and no detected publication bias for OS and RFS.
Conclusions:
- LTT demonstrates no significant oncologic disadvantage (OS, RFS) compared to TP for selected T1-2 low-grade parotid malignancies confined to the superficial lobe.
- High risk of bias in included studies limits definitive conclusions; individualized surgical approach prioritizing negative margins and function is recommended.
- Prospective studies with standardized outcome reporting are needed to confirm findings and guide surgical strategy.