Stodulski Dominik, Mikaszewski Bogusław, Witkowski Paweł, Bartkowiak Ewelina, Pietruszewska Wioletta, Olejniczak Izabela, Markowski Jarosław, Piernicka-Dybich Aleksandra, Burduk Paweł, Wierzchowska Małgorzata, Czech Joanna, Radomska Katarzyna, Chańko Alicja, Majszyk Daniel, Bruzgielewicz Antoni, Gazińska Patrycja, Wierzbicka Małgorzata
Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland.
Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
J Clin Med. 2024 Aug 5;13(15):4574. doi: 10.3390/jcm13154574.
Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to present the characteristics of PGTs with PPS involvement. : Retrospective, multicenter analysis of 1954 primary PGTs from 5 years (2017-2021) was performed. Comparative analysis was performed between groups with and without PPS involvement and included the following clinical and histopathological data: age, sex, place of residence, tumor size, FNAC result, percentage of malignant tumors, histological diagnosis, radicality of resection, and postoperative facial nerve (FN) dysfunction. PPS involvement was found in 114 patients (5.83%). Secondary tumors affecting the deep lobe or the entire gland were predominant (46 and 60 cases, respectively). In a univariate analysis of tumors with and without PPS involvement, statistically significant differences were found in their size > 4 cm (12.97% vs. 37.72%), percentage of malignant tumors (7.12% vs. 17.55%), incidence of Warthin Tumors (WTs) (43.58% vs. 24.56%), percentage of R1 resection (5.53% vs. 12.50%), and rate of FN paresis (17.15% vs. 53.34%). Multivariate analysis showed that tumors with PPS involvement were statistically significantly characterized by larger size (tumors > 4 cm were 2.9 times more frequent), 2 times less frequent occurrence of WTs, and 1.6 times higher risk of FN paresis. PGTs with PPS involvement show certain clinical and histological differences and require more complex surgical accesses. Therefore, they cannot be treated as "ordinary" tumors occupying the deep lobe.
累及咽旁间隙（PPS）的腮腺肿瘤（PGT）具有特定的临床病程，对手术医生来说可能是巨大挑战，尤其是因为手术入路更困难且有严重并发症风险。本研究旨在呈现累及PPS的PGT的特征。对2017年至2021年5年间的1954例原发性PGT进行回顾性多中心分析。对累及PPS和未累及PPS的组进行比较分析，包括以下临床和组织病理学数据：年龄、性别、居住地、肿瘤大小、细针穿刺抽吸活检（FNAC）结果、恶性肿瘤百分比、组织学诊断、切除的根治性以及术后面神经（FN）功能障碍。114例患者（5.83%）发现有PPS累及。影响深叶或整个腺体的继发性肿瘤占主导（分别为46例和60例）。在对累及和未累及PPS的肿瘤进行单因素分析时，发现它们在大小>4 cm（12.97%对37.72%）、恶性肿瘤百分比（7.12%对17.55%）、沃辛瘤（WT）发生率（43.58%对24.56%）、R1切除百分比（5.53%对12.50%）以及FN轻瘫发生率（17.15%对53.34%）方面存在统计学显著差异。多因素分析显示，累及PPS的肿瘤在统计学上具有显著特征，即尺寸更大（肿瘤>4 cm的频率高2.9倍）、WT发生率低2倍以及FN轻瘫风险高1.6倍。累及PPS的PGT表现出一定的临床和组织学差异，需要更复杂的手术入路。因此，它们不能被视为占据深叶的“普通”肿瘤。
