Wertz Aileen P, Durham Alison B, Malloy Kelly M, Johnson Timothy M, Bradford Carol R, McLean Scott A
Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan.
Head Neck. 2017 Aug;39(8):1665-1670. doi: 10.1002/hed.24810. Epub 2017 May 8.
The primary purpose of this study was to describe the parotid recurrence rates after superficial and total parotidectomy.
A retrospective cohort study was performed on patients with cutaneous melanoma metastatic to the parotid gland who underwent parotidectomy from 1998 through 2014. Primary outcome was parotid bed recurrence. Secondary outcomes were facial nerve function postoperatively and at last follow-up.
One hundred twenty-nine patients were included in the study. Thirty-four patients (26%) underwent a total parotidectomy and 95 patients underwent superficial parotidectomy. Twelve patients (13%) developed parotid bed recurrence after superficial parotidectomy alone versus zero after total parotidectomy (P = .035). Facial nerve function, clinically detected disease, stage, and adjuvant treatment were not statistically different between the groups (P = .32, .32, .13, and 0.99, respectively).
Parotid bed melanoma recurrence was more common after superficial parotidectomy compared to total parotidectomy, and recurrence resulted in significant facial nerve functional deficit. Our results support total parotidectomy when metastatic melanoma involves the parotid nodal basin.
本研究的主要目的是描述腮腺浅叶切除术和腮腺全叶切除术后腮腺复发率。
对1998年至2014年接受腮腺切除术的皮肤黑色素瘤转移至腮腺的患者进行回顾性队列研究。主要结局是腮腺床复发。次要结局是术后及最后一次随访时的面神经功能。
129例患者纳入研究。34例（26%）接受了腮腺全叶切除术，95例接受了腮腺浅叶切除术。仅行腮腺浅叶切除术后12例（13%）出现腮腺床复发，而腮腺全叶切除术后无复发（P = 0.035）。两组之间面神经功能、临床检测到的疾病、分期和辅助治疗在统计学上无差异（P分别为0.32、0.32、0.13和0.99）。
与腮腺全叶切除术相比，腮腺浅叶切除术后腮腺床黑色素瘤复发更常见，且复发导致明显的面神经功能缺损。我们的结果支持当转移性黑色素瘤累及腮腺淋巴结区域时行腮腺全叶切除术。
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