Praxis of Otorhinolaryngology

Ibrahim Erdim1, Emrah Sapmaz1, Battal Tahsin Somuk1, Aydin Turan2

1Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalı, Tokat, Türkiye
2Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı, Tokat, Türkiye

Keywords: Cancer, head-neck, metastasis, parotid, skin.

Abstract

OBJECTIVE: In this study, our experience on diagnosis, treatment, and follow-up processes of patients who underwent parotidectomy for head-neck skin cancer (HNSC) was presented.

METHODS: A total of 30 patients (20 male, 10 female; mean age: 76±9.8 year; range, 50 to 90 year) who underwent elective and therapeutic parotidectomy for HNSC between January 2012 and January 2020 were included this retrospective study.

RESULTS: Elective parotidectomy was performed on 11 (36.7%) patients, and therapeutic parotidectomy was performed on 19 (63.3%) patients. Primary tumor histopathology was squamous cell carcinoma in 23 patients, basal cell carcinoma in five patients, and malignant melanoma in two patients. The most frequent primary tumor localizations were auricula (n=9), temple region (n=7), and preauricular region (n=6), respectively. Neck dissection was performed on 25 (83.3%) patients. Postoperative radiotheraphy was applied to 12 (40%) patients. Mean follow-up time was 40.3±30.9 (range, 6 to 99) months. While the three-year survival rate was 90% (9/10) and the five-year survival rate was 77.8% (7/9) in patients who underwent elective parotidectomy, the three-year survival rate was 46.2% (6/13) and the five-year survival rate was 22.2% (2/9) in patients who underwent therapeutic parotidectomy. Both the three-year and five-year survival rates of elective parotidectomy patients were higher than those of therapeutic parotidectomy patients (p<0.05).

CONCLUSION: If regional metastasis, particularly in the parotid gland, occurs in patients with HNSC, the survival rate decreases significantly. Therefore, we believe that elective parotidectomy should be performed on patients with high risk. Neck dissection should be performed when therapeutic parotidectomy is needed, and it must be kept in mind that radiotherapy might be required according to the postoperative pathology report.