Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T23:40:12.677Z Has data issue: false hasContentIssue false
  • English
  • Français

Prognostic factors for secondary recurrence of pleomorphic adenoma: a 20-year, retrospective study

Published online by Cambridge University Press:  20 August 2013

O Malard ,
R Wagner ,
M Joubert ,
A-S Delemazure ,
E Rio ,
N Durand  and
F Espitalier
O Malard*
Affiliation:
Department of Otolaryngology and ENT – Head and Neck Surgery, Nantes University Hospital, Nantes, France
R Wagner
Affiliation:
Department of Otolaryngology and ENT – Head and Neck Surgery, Nantes University Hospital, Nantes, France
M Joubert
Affiliation:
Department of Pathology, Nantes University Hospital, Nantes, France
A-S Delemazure
Affiliation:
Department of Imaging and Radiology, Nantes University Hospital, Nantes, France
E Rio
Affiliation:
Regional Anti-Cancer Centre, Institut Cancérologique de l'Ouest Nantes Atlantique, Saint Herblain, France
N Durand
Affiliation:
Department of Otolaryngology and ENT – Head and Neck Surgery, Nantes University Hospital, Nantes, France
F Espitalier
Affiliation:
Department of Otolaryngology and ENT – Head and Neck Surgery, Nantes University Hospital, Nantes, France
*
Address for correspondence: Professor Olivier Malard, Service d'ORL et de chirurgie cervico-faciale, CHU Hôtel Dieu, 1 Place A Ricordeau, BP 1005, 44093 Nantes, Cedex 01, France Fax: +33 2 40 08 34 77 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose:

To evaluate the results of treatment of parotid pleomorphic adenoma, and the risk factors for secondary recurrence.

Materials and methods:

Single-centre, retrospective study of 32 patients with pleomorphic adenoma recurrence managed between 1988 and 2008.

Results:

The mean age at diagnosis of primary pleomorphic adenoma recurrence was 43.4 years. Twenty-eight per cent of patients had secondary recurrence; 32 per cent had undergone two or more surgical resections and external adjuvant radiotherapy. An age of less than 25 years was significantly associated with an earlier primary recurrence (p = 0.008). The most significant histopathological risk factor for secondary recurrence was the presence of a multifocal tumour (p = 0.019). Other histopathological criteria (i.e. cellularity and capsule rupture) were not significant. Radiotherapy was not associated with a decrease in recurrence. Nine per cent of patients progressed to malignancy. The main surgical complication was definitive facial palsy (14 per cent).

Conclusion:

Pleomorphic adenoma recurrence requires surgery, with greatly increased risk to the facial nerve. Resection with clear surgical margins is required, especially in young patients with multifocal tumours. Radiotherapy may delay second recurrence in cases of multifocal tumour.

Keywords

Adenoma, PleomorphicRecurrenceCancerRadiotherapySurvivalFacial Palsy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 902 - 907
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Chen, CP, Wang, SJ, van Zante, A, Yom, SS. Stepwise regional and distant progression of recurrent pleomorphic adenoma. J Otolaryngol Head Neck Surg 2011;40:5–10Google ScholarPubMed
2Wittekindt, C, Streubel, K, Arnold, G, Stennert, E, Guntinas-Lichius, O. Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients. Head Neck 2007;29:822–8CrossRefGoogle ScholarPubMed
3Seifert, G, Brocheriou, C, Cardesa, A, Eveson, JW. WHO international histological classification of tumours. Tentative histological classification of salivary gland tumours. Pathol Res Pract 1990;186:555–81CrossRefGoogle ScholarPubMed
4Leonetti, JP, Marzo, SJ, Petruzzelli, GJ, Herr, B. Recurrent pleomorphic adenoma of the parotid gland. Otolaryngol Head Neck Surg 2005;133:319–22CrossRefGoogle ScholarPubMed
5Redaelli de Zinis, LO, Piccioni, M, Antonelli, AR, Nicolai, P.Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature. Eur Arch Otorhinolaryngol 2008;265:447–52CrossRefGoogle ScholarPubMed
6Phillips, PP, Olsen, KD. Recurrent pleomorphic adenoma of the parotid gland: report of 126 cases and a review of the literature. Ann Otol Rhinol Laryngol 1995;104:100–4CrossRefGoogle Scholar
7Renehan, A, Gleave, EN, McGurk, M. An analysis of the treatment of 114 patients with recurrent pleomorphic adenomas of the parotid gland. Am J Surg 1996;172:710–14CrossRefGoogle ScholarPubMed
8Laskawi, R, Schott, T, Schroder, M. Recurrent pleomorphic adenomas of the parotid gland: clinical evaluation and long-term follow-up. Br J Oral Maxillofac Surg 1998;36:48–51CrossRefGoogle ScholarPubMed
9Chilla, R. Treatment of recurrent pleomorphic adenoma [in German]. HNO 1997;45:955–6CrossRefGoogle ScholarPubMed
10McGurk, M. Recurrent mixed tumors of the major and minor salivary glands. In: Norman, JEdB, McGurk, M, eds. Colour Atlas and Text of the Salivary Glands: Disease, Disorders and Surgery. London: Mosby-Wolfe, 1995;202–21Google Scholar
11Glas, AS, Hollema, H, Nap, RE, Plukker, JT. Expression of estrogen receptor, progesterone receptor, and insulin-like growth factor receptor-1 and of MIB-1 in patients with recurrent pleomorphic adenoma of the parotid gland. Cancer 2002;94:2211–16CrossRefGoogle ScholarPubMed
12Zbaren, P, Tschumi, I, Nuyens, M, Stauffer, E. Recurrent pleomorphic adenoma of the parotid gland. Am J Surg 2005;189:203–7CrossRefGoogle ScholarPubMed
13Lam, KH, Wei, WI, Ho, HC, Ho, CM. Whole organ sectioning of mixed parotid tumors. Am J Surg 1990;160:377–81CrossRefGoogle ScholarPubMed
14Rodriguez, KH, Vargas, S, Robson, C, Perez-Atayde, A, Shamberger, R, McGill, TJ et al. Pleomorphic adenoma of the parotid gland in children. Int J Pediatr Otorhinolaryngol 2007;71:1717–23CrossRefGoogle ScholarPubMed
15Stennert, E, Wittekindt, C, Klussmann, JP, Arnold, G, Guntinas-Lichius, O. Recurrent pleomorphic adenoma of the parotid gland: a prospective histopathological and immunohistochemical study. Laryngoscope 2004;114:158–63CrossRefGoogle ScholarPubMed
16Carew, JF, Spiro, RH, Singh, B, Shah, JP. Treatment of recurrent pleomorphic adenomas of the parotid gland. Otolaryngol Head Neck Surg 1999;121:539–42CrossRefGoogle ScholarPubMed
17Malard, O, Toquet, C, Gayet-Delacroix, M, Bordure, P, Beauvillain de Montreuil, C, Bardet, E. Radiation-induced cancers of the pharynx and larynx: a study of five clinical cases. Clin Otolaryngol Allied Sci 2002;27:68–74CrossRefGoogle ScholarPubMed
18Niparko, JK, Beauchamp, ML, Krause, CJ, Baker, SR, Work, WP. Surgical treatment of recurrent pleomorphic adenoma of the parotid gland. Arch Otolaryngol Head Neck Surg 1986;112:1180–4CrossRefGoogle ScholarPubMed
19Myssiorek, D. Removal of the inferior half of the superficial lobe is sufficient to treat pleomorphic adenoma in the tail of the parotid gland. Arch Otolaryngol Head Neck Surg 1999;125:1164–5CrossRefGoogle ScholarPubMed
20Lowry, TR, Gal, TJ, Brennan, JA. Patterns of use of facial nerve monitoring during parotid gland surgery. Otolaryngol Head Neck Surg 2005;133:313–18CrossRefGoogle ScholarPubMed