The Clinical and Surgical Characteristics of Parotid Tumors with Parapharyngeal Space Involvement—A Multicenter Experience of the Polish Salivary Network

Author:

Stodulski Dominik1,Mikaszewski Bogusław1ORCID,Witkowski Paweł1,Bartkowiak Ewelina2ORCID,Pietruszewska Wioletta3ORCID,Olejniczak Izabela3,Markowski Jarosław4ORCID,Piernicka-Dybich Aleksandra4,Burduk Paweł5,Wierzchowska Małgorzata5,Czech Joanna5,Radomska Katarzyna6,Chańko Alicja6,Majszyk Daniel7,Bruzgielewicz Antoni7,Gazińska Patrycja89,Wierzbicka Małgorzata101112

Affiliation:

1. Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland

2. Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland

3. Department of Otolaryngology, Head Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland

4. Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland

5. Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 87-100 Bydgoszcz, Poland

6. Department of Otolaryngology, Pomeranian University of Medicine, 70-204 Szczecin, Poland

7. Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland

8. Biobank Research Group, Lukasiewicz Research Network—PORT Polish Center for Technology Development, 54-066 Wroclaw, Poland

9. Research Oncology, Division of Cancer Studies, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9RT, UK

10. Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, 51-124 Wroclaw, Poland

11. Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland

12. Institute of Human Genetics, Polish Academy of Sciences, 01-447 Poznan, Poland

Abstract

Backgrounds/Objectives: Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to present the characteristics of PGTs with PPS involvement. Methods: Retrospective, multicenter analysis of 1954 primary PGTs from 5 years (2017–2021) was performed. Comparative analysis was performed between groups with and without PPS involvement and included the following clinical and histopathological data: age, sex, place of residence, tumor size, FNAC result, percentage of malignant tumors, histological diagnosis, radicality of resection, and postoperative facial nerve (FN) dysfunction. Results: PPS involvement was found in 114 patients (5.83%). Secondary tumors affecting the deep lobe or the entire gland were predominant (46 and 60 cases, respectively). In a univariate analysis of tumors with and without PPS involvement, statistically significant differences were found in their size > 4 cm (12.97% vs. 37.72%), percentage of malignant tumors (7.12% vs. 17.55%), incidence of Warthin Tumors (WTs) (43.58% vs. 24.56%), percentage of R1 resection (5.53% vs. 12.50%), and rate of FN paresis (17.15% vs. 53.34%). Multivariate analysis showed that tumors with PPS involvement were statistically significantly characterized by larger size (tumors > 4 cm were 2.9 times more frequent), 2 times less frequent occurrence of WTs, and 1.6 times higher risk of FN paresis. Conclusion: PGTs with PPS involvement show certain clinical and histological differences and require more complex surgical accesses. Therefore, they cannot be treated as "ordinary" tumors occupying the deep lobe.

Publisher

MDPI AG

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