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腮腺部分切除术治疗低级别黏液表皮样癌的肿瘤学疗效及术后结果

Oncological Efficacy and Postoperative Outcomes of Low Grade Mucoepidermoid Carcinoma Treated With Partial Parotidectomy.

作者信息

Ali Hawa M, Rourk Katelyn S, Byrne Jamie O, Tasche Kendall K, Price Daniel L, Van Abel Kathryn M, Yin Linda X, Moore Eric J

机构信息

Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA.

Department of Quantitative Health Sciences, Rochester, MN, USA.

出版信息

Ann Otol Rhinol Laryngol. 2025 Aug;134(8):606-612. doi: 10.1177/00034894251335405. Epub 2025 May 5.

Abstract

OBJECTIVE

To assess the impact of extent of parotidectomy on surgical and oncologic outcomes in low grade mucoepidermoid carcinoma (LGMEC).

METHODS

A retrospective chart review of all patients undergoing primary surgical treatment for LGMEC from 2000 to 2022 was conducted. Clinical features collected included demographics, facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence.

RESULTS

58 patients were included; 10 patients underwent partial parotidectomy (PP), 38 underwent superficial parotidectomy (SP), and 10 underwent near-total/total parotidectomy. PP and SP patients had smaller tumors and more superficial tumors compared to near-total/total parotidectomy group ( = .03). PP and SP were more likely to have negative margins and less locoregional disease compared to near-total/total parotidectomy patients ( < .01). Near-total/total parotidectomy were more likely to undergo facial nerve resection (20% vs 0% for PP & SP respectively) ( = .05). Immediate postoperative facial nerve function was significantly better among PP patients (73% HB I) compared to SP (44% HB I) and near-total/total parotidectomy patients (0% HB I) ( < .01). Most patients regained their facial nerve function although only 40% of the near-total/total parotidectomy patients had a HB I at the time of last follow up ( < .01). Patients were followed for a median of 6.2 years, during which only 1 patient (total parotidectomy) had a recurrence.

CONCLUSIONS

PP offers a safe and effective approach for small LGMEC tumors, ensuring better facial nerve function postoperatively with minimal complications compared to more extensive surgery.

摘要

目的

评估腮腺切除术范围对低级别黏液表皮样癌(LGMEC)手术及肿瘤学结局的影响。

方法

对2000年至2022年期间接受LGMEC初次手术治疗的所有患者进行回顾性病历审查。收集的临床特征包括人口统计学资料、面神经功能、手术技术、术后并发症/面神经功能以及复发情况。

结果

共纳入58例患者;10例行部分腮腺切除术(PP),38例行浅叶腮腺切除术(SP),10例行近全/全腮腺切除术。与近全/全腮腺切除术组相比,PP组和SP组患者的肿瘤较小且位置更表浅(P = 0.03)。与近全/全腮腺切除术患者相比,PP组和SP组更有可能切缘阴性且局部区域疾病较少(P < 0.01)。近全/全腮腺切除术患者更有可能接受面神经切除(分别为20%,而PP组和SP组为0%)(P = 0.05)。PP组患者术后即刻面神经功能明显优于SP组(73%为House-Brackmann I级)和近全/全腮腺切除术患者(0%为House-Brackmann I级)(P < 0.01)。大多数患者恢复了面神经功能,尽管在最后一次随访时,近全/全腮腺切除术患者中只有40%达到House-Brackmann I级(P < 0.01)。患者的中位随访时间为6.2年,在此期间只有1例患者(全腮腺切除术)复发。

结论

对于小的LGMEC肿瘤,PP提供了一种安全有效的方法,与更广泛的手术相比,术后能确保更好的面神经功能且并发症最少。

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