Treatment of carcinoma of the parotid gland: The results of a multicenter study

Purpose: This study analyzed the prognostic factors for carcinoma of the parotid gland and the role of surgery alone or with radiotherapy in treating these lesions. Methods: Forty-five patients with malignant parotid tumors were studied retrospectively. Patients were treated by combined surgery and radiation therapy between 1984 and 1995 at the Maxillo-Facial Departments of the General Hospitals of Bologna and Parma. Resection was conservative when possible, depending on the extent of the tumor. The median follow-up time was 54 months. Data regarding incidence, tumor stage and grade, local control, distant metastases (calculated with the Kaplan-Meier method), and survival were analyzed. Cox's multiple linear regression was used to identify patient and tumor characteristics with the greatest prognostic significance. Results: The actuarial 5- and 8-year disease-free survival rates were 81% and 62%, respectively. Multivariate analysis showed that tumor stage was a more prognostic variable than tumor grade. Residual microscopic disease at the excision margins was also an important prognostic variable. Laterocervical metastases affected 4 patients (9%), and distant metastases appeared in 8 patients (18%). Conclusions: Postoperative irradiation is indicated for patients with stage III and IV disease, patients with positive excision margins, and for patients with lymph node metastases. (C) 2001 American Association of Oral and Maxillofacial Surgeons.