Surgical options in benign parotid tumors: a proposal for classification
Por:
Quer, M, Poorten, VV, Takes, RP, Silver, CE, Boedeker, CC, de Bree, R, Rinaldo, A, Sanabria, A, Shaha, AR, Pujol, A, Zbaren, P, Ferlito, A
Publicada:
1 nov 2017
Resumen:
Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.
Filiaciones:
Quer, M:
Univ Autonoma Barcelona, Dept Otolaryngol Head & Neck Surg, Univ Hosp Santa Creu & St Pau, Mas Casanovas 90, Barcelona 08041, Spain
European Salivary Gland Soc, Geneva, Switzerland
Poorten, VV:
European Salivary Gland Soc, Geneva, Switzerland
Katholieke Univ Leuven, Sect Head & Neck Oncol, Otorhinolaryngol Head & Neck Surg, Univ Hosp Leuven, Leuven, Belgium
Katholieke Univ Leuven, Sect Head & Neck Oncol, Dept Oncol, Univ Hosp Leuven, Leuven, Belgium
Takes, RP:
Radboud Univ Nijmegen, Dept Otolaryngol Head & Neck Surg, Med Ctr, Nijmegen, Netherlands
Silver, CE:
Univ Arizona, Dept Surg, Coll Med, Phoenix, AZ USA
Boedeker, CC:
HELIOS Hanseklinikum, Dept Otorhinolaryngol Head & Neck Surg, Stralsund, Germany
de Bree, R:
Univ Med Ctr Utrecht, Dept Head & Neck Surg Oncol, Utrecht Canc Ctr, Utrecht, Netherlands
Rinaldo, A:
Univ Udine, Sch Med, Udine, Italy
Sanabria, A:
Univ Antioquia, Dept Surg, Sch Med, Fdn Colombiana Cancerol Clin Vida, Medellin, Colombia
Shaha, AR:
Mem Sloan Kettering Canc Ctr, Head & Neck Serv, 1275 York Ave, New York, NY 10021 USA
Pujol, A:
Univ Autonoma Barcelona, Dept Otolaryngol Head & Neck Surg, Univ Hosp Santa Creu & St Pau, Mas Casanovas 90, Barcelona 08041, Spain
Zbaren, P:
European Salivary Gland Soc, Geneva, Switzerland
Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Bern, Switzerland
Ferlito, A:
Int Head & Neck Sci Grp, Padua, Italy
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