[Primary Parotid Carcinoma: Influence of a Two-step Procedure on the Oncological Outcome]

Background: Malignancies of the parotid gland represent a rare form of head and neck cancer. Advanced stages are usually recognized as such, whereas early tumor stages are sometimes diagnosed only after parotidectomy due to lack of signs of malignancy. The present study investigates whether this unplanned 2-stage approach has a negative impact on the outcome.

Material and methods: The study includes clinical and histological data of patients with parotid cancer which were treated in the Department of Oto-Rhino-Laryngology and Head and Neck Surgery of the University Medical Center Ulm between 2004 and 2014.

Results: 42 patients were included into the study with a median follow-up of 38 months. The RFS and OS at 5 years was 68.6 and 80.1%, respectively, which corresponds to the current literature. 24/42 patients received one-step radical surgery. In 18/42 patients a parotidectomy was performed initially followed by oncologic surgery after receiving histology. The patient group with 2-stage surgery included less advanced tumor stages and more entities with better prognosis. Interestingly, these patients presented with an excellent RFS of 84.4% compared to 56,5% (p=0,16) in the patient group with one-step procedure, correspondent to the tumor stages, entities and the current literature.

Conclusions: According to the available data and compared to the literature, an unplanned 2-stage procedure in clinically silent parotid cancer seems not necessarily to have a negative impact on the outcome. Nevertheless, the preoperative diagnosis should be improved to detect these malignancies more sensitive in early stages.