Colizza Andrea, Di Stadio Arianna, Ralli Massimo, De Luca Pietro, Cavaliere Carlo, Gilardi Antonio, Zoccali Federica, Riminucci Mara, Greco Antonio, Corsi Alessandro, de Vincentiis Marco
Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy.
Department GF Ingrassia, University of Catania, Via di Santa Sofia 87, 95123 Catania, Italy.
Cancers (Basel). 2022 Oct 5;14(19):4862. doi: 10.3390/cancers14194862.
The aim of this study was to systematically review the literature of sarcoma of the parotid gland in order to analyze the main factors affecting survival rate. A systematic literature review was performed between January 1990 to November 2021, and 88 patients affected by parotid gland sarcomas were included. The most common histological types were Rhabdomyosarcoma and Synovial Sarcoma. From our review, it emerges that primary sarcomas of the parotid glands are locally aggressive but show low tendency to metastasize to the lymph nodes of the neck and that surgery (i.e., total or radical parotidectomy) is the main approach for their treatment. The global overall survival (OS) is 52% at 5 years and 34.1% at 10 years. The OS for T1, T2, T3, T4 tumor at 5 years of follow up is 80.0%, 66.5%, 56.7% and 33.3%, respectively. Size/extension at the diagnosis and the sarcoma's histotype are the most important prognostic factors. Multivariate analysis showed that surgery (total or radical parotidectomy) performed on the tumor ( = 0.0008) was the only parameter that significantly affected the OS. Among the other variables, age (younger), use of adjuvant therapy and lymph node metastasis showed borderline significative values ( = 0.05). Our analysis suggests that, when a primitive parotid sarcoma is diagnosed, total or radical parotidectomy should be performed at any age independent of tumor histology. Because regional lymph node metastases from parotid sarcomas are uncommon, alternative strategies (e.g., close follow-up by imaging and evaluation of sentinel lymph nodes) should be pursued before lymph node (selective/radical) dissection.
本研究的目的是系统回顾腮腺肉瘤的文献，以分析影响生存率的主要因素。在1990年1月至2021年11月期间进行了系统的文献回顾，纳入了88例腮腺肉瘤患者。最常见的组织学类型是横纹肌肉瘤和滑膜肉瘤。从我们的回顾中可以看出，腮腺原发性肉瘤具有局部侵袭性，但转移至颈部淋巴结的倾向较低，手术（即全腮腺切除术或根治性腮腺切除术）是其主要治疗方法。全球总生存率（OS）在5年时为52%，在10年时为34.1%。随访5年时，T1、T2、T3、T4肿瘤的OS分别为80.0%、66.5%、56.7%和33.3%。诊断时的大小/范围和肉瘤的组织学类型是最重要的预后因素。多因素分析显示，对肿瘤进行手术（全腮腺切除术或根治性腮腺切除术）（P = 0.0008）是唯一显著影响总生存率的参数。在其他变量中，年龄（较年轻）、辅助治疗的使用和淋巴结转移显示出临界显著值（P = 0.05）。我们的分析表明，当诊断出原发性腮腺肉瘤时，无论肿瘤组织学如何，任何年龄都应进行全腮腺切除术或根治性腮腺切除术。由于腮腺肉瘤的区域淋巴结转移并不常见，在进行淋巴结（选择性/根治性）清扫之前，应采用其他策略（例如，通过影像学密切随访和前哨淋巴结评估）。
