Valstar Matthijs H, Andreasen Simon, Bhairosing Patrick A, McGurk Mark
Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Department of Oral-Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Head Neck. 2020 Aug;42(8):2058-2066. doi: 10.1002/hed.26137. Epub 2020 Mar 18.
Treating recurrent pleomorphic adenoma (RPA) aims to reduce risk of malignant transformation (MT) while avoiding facial nerve injury. Our objective was to systematically investigate this natural history of RPA and address the current rational for its treatment.
The follow-up data of two nationwide series of PA was pooled with a focus on risk of MT and analyzed against the literature.
The combined nationwide data (n = 9003 PA patients) showed 3.1% with first recurrence of which 6.2% were malignant. In the literature first RPA rate was >7% at 20 years follow-up. MT occurred in 0% to 7%, and facial nerve damage increased from with each surgery 3% to 16% at first RPA to 18% to 30% at second RPA.
RPA showed a characteristic course with surgery being unreliable and damage to the facial nerve. The risk of MT was low. This might give flexibility towards a more conservative approach of management.
复发性多形性腺瘤（RPA）的治疗旨在降低恶变风险（MT），同时避免面神经损伤。我们的目的是系统地研究RPA的自然病史，并探讨其当前的治疗依据。
汇总两个全国性多形性腺瘤系列的随访数据，重点关注MT风险，并与文献进行分析对比。
全国合并数据（n = 9003例多形性腺瘤患者）显示，首次复发率为3.1%，其中6.2%为恶性。文献报道，在20年随访时，首次RPA发生率>7%。MT发生率为0%至7%，面神经损伤随着每次手术而增加，首次RPA时从3%增至16%，第二次RPA时从18%增至30%。
RPA呈现出一种特征性病程，手术不可靠且会损伤面神经。MT风险较低。这可能为采取更保守的管理方法提供灵活性。
