Jecker P, Hartwein J
ENT Clinic Eppendorf, University of Hamburg, Federal Republic of Germany.
Am J Otolaryngol. 1996 Mar-Apr;17(2):102-5. doi: 10.1016/s0196-0709(96)90004-6.
At the time of this writing, it is unclear whether metastasis to the parotid gland necessitates a radical surgical approach, including removal of the facial nerve, which results in a great loss of the patient's quality of life.
The clinical course of patients who underwent parotid surgery in the ENT clinic of Hamburg University during the period 1982-1992 as a result of metastasis of a malignant melanoma or squamous cell carcinoma was studied. Either the lateral portion of the gland was removed (laterofacial parotidectomy) or the whole gland, thereby preserving the facial nerve (total parotidectomy) or removing it (radical parotidectomy).
Metastasis to the parotid gland occurred in 17 patients (17/347). All 10 patients with metastasis of a malignant melanoma developed further metastasis and 7 of these patients, independent of the radicality of parotid surgery, died within the first postoperative year. Of the 7 patients with metastasis of a squamous cell carcinoma, 5 developed further metastasis and 4, independent of the radicality of parotid surgery, died within 16 months after the operation.
Radical parotid surgery, which involves a great loss of quality of life for the patient, does not positively influence life expectancy. Moreover, the long-term prognosis is influenced by the type of the tumor and the stage at which the disease is first diagnosed.
在撰写本文时，尚不清楚腮腺转移瘤是否需要采取根治性手术方法，包括切除面神经，而这会导致患者生活质量大幅下降。
对1982年至1992年期间在汉堡大学耳鼻喉科诊所因恶性黑色素瘤或鳞状细胞癌转移而接受腮腺手术的患者的临床病程进行了研究。要么切除腺体的外侧部分（面外侧腮腺切除术），要么切除整个腺体，同时保留面神经（全腮腺切除术）或切除面神经（根治性腮腺切除术）。
17例患者（17/347）发生了腮腺转移。所有10例恶性黑色素瘤转移患者均出现了进一步转移，其中7例患者，无论腮腺手术的根治程度如何，均在术后第一年内死亡。在7例鳞状细胞癌转移患者中，5例出现了进一步转移，4例无论腮腺手术的根治程度如何，均在术后16个月内死亡。
根治性腮腺手术会给患者的生活质量带来巨大损失，对预期寿命没有积极影响。此外，长期预后受肿瘤类型和疾病首次诊断时的分期影响。
