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Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise

Previous studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tu...

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Autores principales: McGurk, M, Thomas, B L, Renehan, A G
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394403/
https://www.ncbi.nlm.nih.gov/pubmed/14583757
http://dx.doi.org/10.1038/sj.bjc.6601281
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author McGurk, M
Thomas, B L
Renehan, A G
author_facet McGurk, M
Thomas, B L
Renehan, A G
author_sort McGurk, M
collection PubMed
description Previous studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tumour masquerades as a clinically benign lump, this approach may be inappropriate. This study addressed this question by analysing the outcome of 821 consecutive patients with parotid tumours treated at one centre over 40 years and with a median 12 (range 5–30) years follow-up. Tumours were classified as ‘simple’ (discrete, mobile, < 4 cm: n=662) and ‘complex’ (deep, fixed, facial nerve palsy, ⩾4 cm: n=159). Among the ‘simple’ or clinically benign tumours, 503 patients underwent ECD; 159 patients underwent SP. In all, 32 (5%) clinically benign cases were subsequently revealed as malignant histologies (ECD, 12; SP, 20). For each group, 5- and 10-year cancer-specific survival rates were 100 and 98%, respectively. There were no differences in recurrence rates when subanalysed by surgical groups, but ECD was associated with significantly reduced morbidity (P < 0.001). This study demonstrates that ECD is a viable alternative to superficial parotidectomy for the majority of parotid tumours, associated with reduced morbidity without oncological compromise.
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spelling pubmed-23944032009-09-10 Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise McGurk, M Thomas, B L Renehan, A G Br J Cancer Clinical Previous studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tumour masquerades as a clinically benign lump, this approach may be inappropriate. This study addressed this question by analysing the outcome of 821 consecutive patients with parotid tumours treated at one centre over 40 years and with a median 12 (range 5–30) years follow-up. Tumours were classified as ‘simple’ (discrete, mobile, < 4 cm: n=662) and ‘complex’ (deep, fixed, facial nerve palsy, ⩾4 cm: n=159). Among the ‘simple’ or clinically benign tumours, 503 patients underwent ECD; 159 patients underwent SP. In all, 32 (5%) clinically benign cases were subsequently revealed as malignant histologies (ECD, 12; SP, 20). For each group, 5- and 10-year cancer-specific survival rates were 100 and 98%, respectively. There were no differences in recurrence rates when subanalysed by surgical groups, but ECD was associated with significantly reduced morbidity (P < 0.001). This study demonstrates that ECD is a viable alternative to superficial parotidectomy for the majority of parotid tumours, associated with reduced morbidity without oncological compromise. Nature Publishing Group 2003-11-03 2003-10-28 /pmc/articles/PMC2394403/ /pubmed/14583757 http://dx.doi.org/10.1038/sj.bjc.6601281 Text en Copyright © 2003 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Clinical
McGurk, M
Thomas, B L
Renehan, A G
Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
title Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
title_full Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
title_fullStr Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
title_full_unstemmed Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
title_short Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
title_sort extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise
topic Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394403/
https://www.ncbi.nlm.nih.gov/pubmed/14583757
http://dx.doi.org/10.1038/sj.bjc.6601281
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