Safety and Efficacy of Radiofrequency Ablation for Superficial Parotid Pleomorphic Adenoma.

OBJECTIVE

To retrospectively compare the safety and efficacy of ultrasound-guided radiofrequency ablation (RFA) with parotidectomy for superficial pleomorphic adenoma (PA).

MATERIALS AND METHODS

From March 2022 to October 2023, 88 patients diagnosed with superficial parotid PA underwent either RFA (n = 12; mean age, 47.1 years) or parotidectomy (n = 76; mean age, 47.8 years). Patients in the RFA group were matched to those in the surgery group in a 1:1 ratio using propensity scores based on age, sex, tumor volume, diameter, location, and comorbidities. Ultrasound characteristics, cosmetic scores (0-4), numerical rating scale scores (0-10), and complications were assessed before the procedures and at 1-, 3-, and 6-month follow-ups. Outcomes were compared between baseline and follow-up in the RFA group and between the RFA and surgery groups.

RESULTS

In the RFA group, significant reductions in tumor volume were observed between baseline (median, 2.02 cm³) and the 1-month follow-up (median, 1.21 cm³; = 0.015), between the 1-month and 3-month follow-ups (median, 0.53 cm³; = 0.002), and between the 3- and 6-month follow-ups (median, 0.23 cm³; = 0.003). The volume reduction ratios at 1, 3, and 6 months were 39.7%, 79.9%, and 88.0%, respectively. The cosmetic score was significantly lower at 3- and 6-month follow-up compared to baseline (median 1 and 1 vs. 4, = 0.04). The numerical rating scale scores did not differ significantly from baseline throughout follow-up. In the propensity score-matched analysis (12 patients per group), RFA was associated with a shorter median procedure time (61.5 vs. 253.3 minutes; < 0.001), shorter hospital stay (0 vs. 4 days; < 0.001), and lower cost (1859.9 vs. 3512.4 USD; < 0.001) than parotidectomy, with no significant difference in overall complication rates (33.3% [4/12] vs. 41.7% [5/12]; = 1.000).

CONCLUSION

RFA may be a safe and effective alternative to surgery for superficial parotid PA, offering a shorter median procedure time, shorter hospital stay, and lower costs.