-
Otolaryngologia Polska = the Polish... Dec 2020<b>Introduction:</b> Parotid gland neoplasms represent a heterogenous group of tumors, either benign or malignant. The diagnosis and management of parotid...
<b>Introduction:</b> Parotid gland neoplasms represent a heterogenous group of tumors, either benign or malignant. The diagnosis and management of parotid gland tumors is complicated by their relative infrequency and their diverse biologic behavior. <br><b>Aim:</b> The aim of this study is to investigate the epidemiological characteristics, the recurrence rates and the surgical approach employed for parotid gland tumors in Northern Greece. <br><b>Material and methods:</b> This is a single-center retrospective study. All patients admitted to the ENT department of "G. Papanikolaou" General Hospital of Thessaloniki from January 2012 to June 2019 with the diagnosis of parotid gland tumor were included in the study. Patients with incomplete charts and patients that underwent revision surgeries were excluded. Chi-squared tests were used to assess the associations between variables. <br><b>Results:</b> A total of 207 patients with a mean age of 54.97 (range 16-91) were included in the study. Benign neoplasms accounted for 87.9% of the cases. Warthin's tumor was the most common neoplasm encountered, with an incidence of 46.8%, followed by pleomorphic adenoma (31.9%). There was a higher incidence of parotid gland tumors in males and smokers (P = 0.025, P = 0.001 respectively). The majority of the patients were treated with an extracapsular resection (60.4%) or with a partial superficial parotidectomy (22.6%). In 12 cases (5.7%), there was a recurrence of the lesion. The most common complications encountered were facial nerve injury, Frey's syndrome and hematoma formation. <br><b>Conclusions:</b> Parotid gland tumors are typically benign, non-aggressive tumors, more frequently seen in men than women. There is a positive association between smoking and parotid gland tumor development. Comprehensive information regarding recurrence and complication rates is presented.
Topics: Adenoma, Pleomorphic; Female; Greece; Humans; Male; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Retrospective Studies
PubMed: 33724229
DOI: 10.5604/01.3001.0014.5731 -
BMC Cancer Feb 2021Early detection and diagnosis of parotid gland cancer (PGC) are essential to improve clinical outcomes, because Tumor-Node-Metastasis stage at diagnosis is a very strong...
BACKGROUND
Early detection and diagnosis of parotid gland cancer (PGC) are essential to improve clinical outcomes, because Tumor-Node-Metastasis stage at diagnosis is a very strong indicator of prognosis in PGC. Nevertheless, some patients still present with large parotid mass, maybe due to the unawareness or ignorance of their disease. In this study, we aimed to present the clinical outcomes of bulky PGC (defined by a 4 cm cutoff point for T3-4 versus T1-2 tumors), to emphasize the necessity of a self-examination tool for parotid gland tumor.
METHODS
We retrospectively reviewed 60 consecutive cases with bulky (equal to and greater than 4 cm in the longest diameter, determined radiologically) malignant tumors arising from the parotid gland from 1995 to 2016. The clinical and pathological factors were analyzed to identify risk factors for poor outcomes using Cox proportional hazard models. In addition, we designed a self-examination tool for parotid gland tumors, similar to breast self-examination for breast cancer detection.
RESULTS
Patients with bulky parotid cancer showed 48.9% 5-year and 24.5% 10-year overall survival rates and a 47.9% risk of high-grade malignancy. The common pathological diagnoses were carcinoma ex pleomorphic adenoma (18.3%), adenocarcinoma (16.7%), mucoepidermoid carcinoma (16.7%), salivary duct carcinoma (16.7%), and adenoid cystic carcinoma (11.7%). Survival analyses revealed that tumor size (hazard ratio, HR = 1.262 upon increase of 1 cm, 95% confidence interval, 95%CI 1.059-1.502), lymph node metastasis (HR = 2.999, 95%CI 1.048-8.583), and high tumor grade (HR = 4.148, 95%CI 1.215-14.154) were independent prognostic factors in multivariable analysis. Functional preservation of the facial nerve was possible only in less than half of patients.
CONCLUSION
In bulky PGC, lymph node metastasis at diagnosis and high tumor grade indicated poor survival outcomes, and functional outcomes of the facial nerve were suboptimal. Thus, a public effort seems to be necessary to decrease these patients with bulky PGC, and to increase patients' self-awareness of their disease. As a way of early detection, we proposed a parotid self-examination tool to detect parotid gland tumors at an early stage, which is similar to breast self-examination.
Topics: Adenocarcinoma; Adenoma, Pleomorphic; Aged; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Early Detection of Cancer; Female; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Parotid Neoplasms; Prognosis; Retrospective Studies; Self-Examination; Survival Rate; Treatment Outcome; Tumor Burden
PubMed: 33602169
DOI: 10.1186/s12885-021-07902-9 -
Brazilian Journal of Otorhinolaryngology 2020Recently it has been reported that a high preoperative neutrophil-lymphocyte ratio and platelet-lymphocyte ratio may be related to increased recurrence risk, tumor...
INTRODUCTION
Recently it has been reported that a high preoperative neutrophil-lymphocyte ratio and platelet-lymphocyte ratio may be related to increased recurrence risk, tumor aggressiveness, and worsened prognosis in various malignancies.
OBJECTIVE
The objective of this research is to explore whether neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in parotid tumors may or may not be used as a cancer marker.
METHODS
This retrospective research has been conducted on a total of 228 patients consisting of 83 healthy persons and 145 patients with a mass in the parotid gland, who applied to a tertiary referral center and underwent surgery. Patients have been divided into two groups by their histopathological findings as malignant or benign parotid tumor. A third group consisting of healthy people has been defined as the control group. Also the malignant parotid tumor group has been divided into two subgroups as early stage and advanced stage. The groups have been compared in terms of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and other laboratory data.
RESULTS
The average neutrophil-lymphocyte ratio values of malignant parotid tumor, benign parotid tumor, healthy control groups were 2.51, 2.01, 1.79 respectively and the difference was statistically significant (p<0.001). There was no significant difference between advanced stage and early stage parotid tumor groups in terms of average neutrophil-lymphocyte ratio value (p=0.782). In dual comparisons, the platelet-lymphocyte ratio value of patients in the malignant group was found out to be statistically significantly higher than that of benign and control groups (p<0.001 and p=0.001 respectively).
CONCLUSION
To the best of our knowledge our research is the first in the medical literature comparing neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with parotid tumor. neutrophil-lymphocyte ratio and platelet-lymphocyte ratio can serve as cost-effective, repeatable, easily accessible, and helpful inflammatory markers in order to distinguish patients with malignant parotid tumor from healthy people.
Topics: Adenoma, Pleomorphic; Adult; Carcinoma, Squamous Cell; Environmental Biomarkers; Female; Humans; Lymphocyte Count; Lymphocytes; Male; Middle Aged; Neoplasm Staging; Neutrophils; Parotid Neoplasms; Platelet Count; Preoperative Care; Prognosis; Retrospective Studies
PubMed: 31122885
DOI: 10.1016/j.bjorl.2019.02.009 -
Journal of Otolaryngology - Head & Neck... Nov 2019Parotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction...
BACKGROUND
Parotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy is utilized to address contour deformity and facial nerve paralysis. This study aims to demonstrate national trends in parotidectomy patients and identify factors associated with adverse postoperative outcomes. This study includes the largest patient database to date in determining epidemiologic trends, reconstructive trends, and prevalence of adverse events following parotidectomy.
METHODS
A retrospective review was performed for parotidectomies included in the ACS-NSQIP database between January 2012 and December 2017. CPT codes were used to identify the primary and secondary procedures performed. Univariate and multivariate analysis was utilized to determine associations between pre- and perioperative variables with patient outcomes. Preoperative demographics, surgical indications, and common medical comorbidities were collected. CPT codes were used to identify patients who underwent parotidectomy with or without reconstruction. These pre- and perioperative characteristics were compared with 30-day surgical complications, medical complications, reoperation, and readmission using uni- and multivariate analyses to determine predictors of adverse events.
RESULTS
There were 11,057 patients who underwent parotidectomy. Postoperative complications within 30 days were uncommon (1.7% medical, 3.8% surgical), with the majority of these being surgical site infection (2.7%). Free flap reconstruction, COPD, bleeding disorders, smoking, and presence of malignant tumor were the strongest independent predictors of surgical site infection. Readmission and reoperation were uncommon at an incidence of 2.1% each. The strongest factors predictive of readmission were malignant tumor and corticosteroid usage. The strongest factors predictive of reoperation were free flap reconstruction, malignant tumor, bleeding disorder, and disseminated cancer. Surgical volume/contour reconstruction was relatively uncommon (18%). Facial nerve sacrifice was uncommon (3.7%) and, of these cases, only 25.5% underwent facial nerve reinnervation and 24.0% underwent facial reanimation.
CONCLUSIONS
There are overall low rates of complications, readmissions, and reoperations following parotidectomy. However, certain factors are predictive of adverse postoperative events and this data may serve to guide management and counseling of patients undergoing parotidectomy. Concurrent reconstructive procedures are not commonly reported which may be due to underutilization or underreporting.
Topics: Aged; Aged, 80 and over; Female; Humans; Incidence; Male; Middle Aged; Parotid Neoplasms; Patient Readmission; Postoperative Complications; Plastic Surgery Procedures; Reoperation; Retrospective Studies; United States
PubMed: 31744535
DOI: 10.1186/s40463-019-0387-y -
BMC Cancer Oct 2015It is difficult for the parotid gland neoplasms to make an accurate preoperative diagnosis due to the restriction of biopsy in the parotid gland neoplasms. The aim of...
BACKGROUND
It is difficult for the parotid gland neoplasms to make an accurate preoperative diagnosis due to the restriction of biopsy in the parotid gland neoplasms. The aim of this study is to apply the surface-enhanced Raman spectroscopy (SERS) method for the blood serum biochemical detection and use the support vector machine for the analysis in order to develop a simple but accurate blood serum detection for preoperative diagnosis of the parotid gland neoplasms.
METHODS
The blood serums were collected from four groups: the patients with pleomorphic adenoma, the patients with Warthin's tumor, the patients with mucoepidermoid carcinoma and the volunteers without parotid gland neoplasms. Au nanoparticles (Au NPs) were mixed with the blood serum as the SERS active nanosensor to enhance the Raman scattering signals produced by the various biochemical materials and high quality SERS spectrum were obtained by using the Raman microscope system. Then the support vector machine was utilized to analyze the differences of the SERS spectrum from the blood serum of different groups and established a diagnostic model to discriminate the different groups.
RESULTS
It was demonstrated that there were different intensities of SERS peaks assigned to various biochemical changes in the blood serum between the parotid gland tumor groups and normal control group. Compared with the SERS spectra of the normal serums, the intensities of peaks assigned to nucleic acids and proteins increased in the SERS spectra of the parotid gland tumor serums, which manifested the differences of the biochemical metabolites in the serum from the patients with parotid gland tumors. When the leave-one-sample-out method was used, support vector machine (SVM) played an outstanding performance in the classification of the SERS spectra with the high accuracy (84.1 % ~ 88.3 %), sensitivity (82.2 % ~ 97.4 %) and specificity (73.7 % ~ 86.7 %). Though the accuracy, sensitivity and specificity decreased in the leave-one-patient-out cross validation, the mucoepidermoid carcinoma was still easier to diagnose than other tumors.
DISCUSSION
The specific molecular differences of parotid gland tumors and normal serums were significantly demonstrated through the comparison between the various SERS spectra.But compared with the serum SERS spectra reported in the other studies, some differences exist between the spectra in this study and the ones reported in the lietratures. These differences may result from the various nano-particles, the different preparation of serum and equipment parameters, and we could need a further research to find an exact explanation.Based on the SERS spectra of the serum samples, SVM have shown a giant potential to diagnose the parotid gland tumors in our preliminary study. However, different cross validaiton methods could effect the accuracy and a further study involing a great number of samples should be needed.
CONCLUSIONS
This exploratory research demonstrated the great potential of SERS combined with SVM into a non-invasive clinical diagnostic method for preoperative diagnosis of parotid gland tumors. And the internal relation between the spectra and patients should be established in the further study.
Topics: Adolescent; Adult; Aged; Biomarkers; Female; Humans; Male; Middle Aged; Parotid Neoplasms; Preoperative Care; Spectrum Analysis, Raman; Support Vector Machine; Young Adult
PubMed: 26438216
DOI: 10.1186/s12885-015-1653-7 -
The Journal of Investigative Dermatology Jul 2019Cutaneous squamous cell carcinoma from the head and neck typically metastasize to the lymph nodes of the neck and parotid glands. When a primary is not identified, they...
Cutaneous squamous cell carcinoma from the head and neck typically metastasize to the lymph nodes of the neck and parotid glands. When a primary is not identified, they are difficult to distinguish from metastases of mucosal origin and primary salivary gland squamous cell carcinoma. UV radiation causes a mutation pattern that predominantly features cytosine to thymine transitions at dipyrimidine sites and has been associated with cutaneous squamous cell carcinoma. In this study, we used whole genome sequencing data from 15 cutaneous squamous cell carcinoma metastases and show that a UV mutation signature is pervasive across the cohort and distinct from mucosal squamous cell carcinoma. The mutational burden was exceptionally high and concentrated in some regions of the genome, especially insulator elements (mean 162 mutations/megabase). We therefore evaluated the likely impact of UV-induced mutations on the dipyrimidine-rich binding site of the main human insulator protein, CCCTC-binding factor, and the possible implications on CCCTC-binding factor function and the spatial organization of the genome. Our findings suggest that mutation signature analysis may be useful in determining the origin of metastases in the neck and the parotid gland. Furthermore, UV-induced DNA damage to insulator binding sites may play a role in the carcinogenesis and progression of cutaneous squamous cell carcinoma.
Topics: Adult; Aged; CCCTC-Binding Factor; Carcinoma, Squamous Cell; Cohort Studies; DNA Mutational Analysis; Female; Humans; Lymphatic Metastasis; Male; Middle Aged; Mutation; Neoplasm Metastasis; Parotid Neoplasms; Skin Neoplasms; Ultraviolet Rays; Whole Genome Sequencing
PubMed: 30684551
DOI: 10.1016/j.jid.2019.01.008 -
European Review For Medical and... Jul 2018To investigate the effect of hMTH1 (human mutT homologue 1) on inducing the metastasis and recurrence of parotid adenoma, which may provide a new therapeutic direction...
OBJECTIVE
To investigate the effect of hMTH1 (human mutT homologue 1) on inducing the metastasis and recurrence of parotid adenoma, which may provide a new therapeutic direction for the prevention and treatment of parotid adenoma.
PATIENTS AND METHODS
30 cases of paraffin-embedded specimens of parotid adenoid cystic carcinoma (ACC) tissues and fresh parotid glands surgically resected in our hospital were collected as experimental group. 30 cases of surgically resected pleomorphic adenoma (PA) in the same period were selected as another experimental group. Meanwhile, 30 cases of normal parotid gland tissues (N) were collected as control group. The mRNA and protein expressions of hMTH1 in parotid gland tissues of patients with parotid adenoma before and after surgery were detected by Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and Western blotting, respectively. HMTH1 expression levels in parotid gland tissues were also detected by immunohistochemistry. Proliferation, apoptosis and DNA damage of ACC-M cells treated with S-Crizotinib were detected by cell counting kit-8 (CCK-8) assay, flow cytometry and single cell gel electrophoresis, respectively.
RESULTS
Both mRNA and protein expressions of hMTH1 in experimental group were significantly higher than those of control group. Moreover, a higher expression of hMTH1 was observed in ACC than that of PA, indicating that hMTH1 expression was positively correlated with the malignant degree of parotid adenoma. Furthermore, postoperative hMTH1 expression levels in patients with parotid adenoma were significantly lower than those before treatment, which were remarkably increased in recurrent patients. In vitro experiments demonstrated that S-Crizotinib, the hMTH1 inhibitor, could inhibit proliferation and induce apoptosis and DNA damage of ACC-M cells.
CONCLUSIONS
HMTH1 was upregulated in patients with parotid adenoma and recurrent patients after surgery. Meanwhile, S-Crizotinib induced DNA damage in ACC-M cells, indicating that hMTH1 induced the metastasis and recurrence of parotid adenoma by repairing DNA damage, providing a new strategy for the prevention and treatment of parotid adenoma.
Topics: Adenoma, Pleomorphic; Adolescent; Adult; Aged; Apoptosis; Carcinoma, Adenoid Cystic; Case-Control Studies; Cell Proliferation; Child; Crizotinib; DNA Damage; DNA Repair Enzymes; Humans; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Phosphoric Monoester Hydrolases; Young Adult
PubMed: 30024628
DOI: 10.26355/eurrev_201807_15435 -
Journal of Global Oncology Sep 2018This meta-analysis aimed to review the published outcomes of parotid non-Hodgkin lymphoma (NHL) pertaining to different treatment modalities. (Meta-Analysis)
Meta-Analysis
PURPOSE
This meta-analysis aimed to review the published outcomes of parotid non-Hodgkin lymphoma (NHL) pertaining to different treatment modalities.
MATERIALS AND METHODS
A total of 48 journal articles published between 1993 and 2015, comprising 742 cases of parotid NHL, were initially evaluated. In total, 108 patients from 12 studies who had sufficient data for analysis, including age, tumor histopathology, treatment modality, and outcome at final follow-up, were included. Patients were randomly assigned to different categories on the basis of histopathology and treatment modality. Groups were compared using Kaplan-Meier survival curve analysis and the Mann-Whitney U test.
RESULTS
Log-rank tests demonstrated that for early-stage (I and II) parotid NHL of all histopathology variants, radiation therapy significantly improved the survival rate versus chemotherapy ( P = .043), as well as combined treatment with chemotherapy and radiation therapy ( P = .023). For early-stage diffuse large B-cell lymphoma, combined treatment significantly improved survival versus single treatment ( P = .028). No treatment was received by seven patients with early-stage mucosa-associated lymphoid tissue lymphoma after undergoing parotidectomy. When the clinical outcomes of these patients were compared with those of other patients with the same histology who underwent further treatment, no significant differences were noted in survival outcomes.
CONCLUSION
Radiation therapy seems to be a valid treatment of early-stage parotid NHL. However, for diffuse large B-cell lymphoma, survival was higher with combined treatment versus single treatment. For early-stage parotid mucosa-associated lymphoid tissue lymphoma, complete excision of the tumor through superficial parotidectomy may have similar survival outcome.
Topics: Female; Humans; Lymphoma, Non-Hodgkin; Middle Aged; Parotid Neoplasms; Survival Analysis
PubMed: 30241143
DOI: 10.1200/JGO.17.00071 -
Medical Ultrasonography Sep 2010The purpose of this pictorial essay is to illustrate the ultrasonographic aspects of the most common benign tumors of the parotid gland: pleomorphic adenoma and... (Review)
Review
The purpose of this pictorial essay is to illustrate the ultrasonographic aspects of the most common benign tumors of the parotid gland: pleomorphic adenoma and Warthin's tumor. The gray scale and Doppler ultrasonographic findings of the two tumors are reviewed and exemplified.
Topics: Adenolymphoma; Adenoma, Pleomorphic; Humans; Parotid Neoplasms; Ultrasonography, Doppler
PubMed: 21203603
DOI: No ID Found -
Acta Otorhinolaryngologica Italica :... Jun 2019
Topics: Adenoma, Pleomorphic; Adolescent; Adult; Aged; Child; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Submandibular Gland; Treatment Outcome; Young Adult
PubMed: 31131834
DOI: 10.14639/0392-100X-2307