Parotid cancer in Auckland 1970-1986--too little, too late.

We have reviewed the records of 98 parotid cancer patients seen in Auckland over the seventeen year period January 1970 to December 1986. The average duration of symptoms prior to receiving surgical attention was fifteen months and 58% of patients had stage III disease on presentation. The histological profile of our group of patients was different from that reported in other series with increased numbers of patients having bad outlook tumours. There were seven histological types of parotid cancer and these could be divided into two distinct prognostic groups with mucoepidermoid, malignant mixed, adenoid cystic and acinic cell comprising the more indolent tumours and squamous cell, undifferentiated and adenocarcinoma following a more agressive course. The overall five year cure rate was 35%: 65% of patients were either dead or had developed recurrent disease within this period. Radiotherapy appeared to be beneficial for stage I and II lesions, but in advanced cases it had no obvious impact on survival. The initial surgery for parotid cancer should comprise at least a superficial parotidectomy plus a suprahyoid neck dissection if possible. In addition, patients with positive nodes or more aggressive histology should undergo radical neck dissection. All patients with parotid cancer should have adjuvant radiotherapy.