Primary parotid cancer: factors influencing recurrence

Recurrent disease was evaluated in 82 patients with primary parotid cancer as a function of multiple parameters including cell type, stage of disease, and extent of surgery. Stage III disease had the highest rate of recurrence (89%). Recurrence in Stage III disease appeared independent of extent of primary surgical management. The poor prognosis, 12 per cent survival at five years, associated with recurrence suggests adjuvant modalities should be utilized in the initial treatment of Stage III disease. In Stage I disease, the extent of surgery becomes more critical. In patients with Stage I disease and low-grade malignancies, superficial parotidectomy is an acceptable method of treatment. This is valid provided surgical margins are free of disease. However, patients with high-grade malignancies and Stage I disease undergoing superficial parotidectomy have a high rate of recurrence, 45 per cent of our cases. The results suggest that more extensive surgery and/or adjuvant radiation should be utilized in this subgroup of patients.