Clinical History, Prognostic Factors, and Management of Facial Nerve in Malignant Tumors of the Parotid Gland

OBJECTIVES: We analyzed the outcomes following clinical management of parotid masses that were determined to be malignant tumors after parotidectomy. METHODS: We evaluated data from 70 patients with parotid malignancies between November 1994 and December 2005. RESULTS: Among salivary histotypes (n=49), the most significant prognostic parameter was cT4 stage at diagnosis (P=0.0055, log-rank) both for clinical involvement of the facial nerve and for invasion of other structures. The main cause of cancer-related death was a distant metastasis. CONCLUSION: The present series confirms that the main prognostic parameter in salivary parotid malignancies was cT4 classification at diagnosis, often due to clinical involvement of the facial nerve. The oncological outcome of salivary malignancies was influenced by distant metastasis more than most other head and neck sites. We recommend dissecting and preserving the functioning VIIth cranial nerve during surgery for parotid malignancies.