ENT Department, Doncaster Royal Infirmary, Doncaster, UK.
ENT Department, Sheffield Teaching Hospitals Foundation Trust, UK.
J Laryngol Otol. 2023 Jun;137(6):592-598. doi: 10.1017/S0022215122001724. Epub 2022 Aug 1.
The extent of parotidectomy in the management of regional metastatic disease is controversial. This systematic review aimed to appraise data from studies evaluating superficial and total parotidectomy in metastatic cutaneous squamous cell carcinoma and cutaneous malignant melanoma of the head and neck.
A systematic search of PubMed, Embase and Cochrane Library was performed. The protocol was registered with Prospero (CRD42020217962).
A total of five studies evaluated cutaneous malignant melanoma. Only one compared outcomes of superficial and total parotidectomy: they found higher parotid area recurrence following superficial parotidectomy. Seven studies reported outcomes following cutaneous squamous cell carcinoma; some studies found higher regional recurrence and reduced survival in total parotidectomy, but there was likely selection bias in these studies. Others found no difference in survival between superficial and total parotidectomy.
The effect of the extent of parotidectomy on outcomes is unclear in cutaneous malignant melanoma and cutaneous squamous cell carcinoma. This systematic review highlights the need for well-designed studies to direct better care.
在区域性转移性疾病的治疗中,腮腺切除术的范围存在争议。本系统评价旨在评估评估头颈部转移性皮肤鳞状细胞癌和皮肤恶性黑色素瘤中腮腺浅叶和全切除术的研究数据。
对 PubMed、Embase 和 Cochrane Library 进行了系统检索。该方案已在 Prospero(CRD42020217962)中注册。
共有 5 项研究评估了皮肤恶性黑色素瘤。只有一项研究比较了腮腺浅叶和全切除术的结果:他们发现腮腺浅叶切除后腮腺区复发率更高。7 项研究报告了皮肤鳞状细胞癌的治疗结果;一些研究发现全腮腺切除术的局部复发率更高,生存率降低,但这些研究可能存在选择偏倚。其他研究发现腮腺浅叶切除术和全腮腺切除术之间的生存率没有差异。
在皮肤恶性黑色素瘤和皮肤鳞状细胞癌中,腮腺切除术范围对预后的影响尚不清楚。本系统评价强调需要精心设计的研究来指导更好的治疗。