Prognosis of Surgically Treated Primary Parotid Gland Cancer - an Evaluation of 231 Cases

Objective: We present our results on the prognosis of parotid gland cancer with the help of a group of patients who were treated in a standardised manner and received a long term follow-up. Material and Methods: We retrospectively analysed the clinicopathological data of 231 patients with a surgically treated primary parotid gland cancer and calculated survival parameters. The mean follow-up time was 52 months. Results: The 5- and 10-year overall survival rate was 74.2 % and 66.9 %. 70 patients got a locoregional recurrence, 18.6% of those even after more than 5 years. Initial facial nerve palsy was a significant negative prognostic indicator for the disease-free survival. The most frequent histological subtypes could be divided into 3 prognostic groups with significant differences in the survival. The pathological tumour stage was a prognostic indicator for a worse overall and disease-free survival. The pT-stage, the pN-stage and the existence of distant metastases were independent prognostic factors. Conclusions: The group of patients is mainly characterised by the large size, the standardised therapy and the long follow-up time. We could show that the facial nerve palsy is a severe negative prognostic factor. For practical purpose, the classification into 3 histological subgroups seemed to be of great help. This should be considered in patient follow-up. Due to the amount of late recurrences, we propose a follow-up time longer than 5 years. We propose standardized surgery including total parotidectomy in combination with neck dissection