Surgical Management of Patients with Parotid Involvement from Non-Melanoma Skin Cancer of the Head and Neck

Author:

Carta Filippo1ORCID,Corrias Simone1ORCID,Tatti Melania1,Marrosu Valeria1,Bontempi Mauro1,Mariani Cinzia1ORCID,Gerosa Clara2,Ferreli Caterina3ORCID,Atzeni Matteo4ORCID,Boriani Filippo4,Figus Andrea4,Puxeddu Roberto15ORCID

Affiliation:

1. Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

2. Unit of Pathology, Department of Medical Sciences and Public Health, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

3. Unit of Dermatology, Department of Medical Sciences, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

4. Unit of Plastic Surgery, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

5. Unit of Otorhinolaryngology, Department of Surgery, King’s College Hospital London-Dubai, Dubai P.O. Box 340901, United Arab Emirates

Abstract

We conducted a retrospective, longitudinal study on a single-center series of patients who underwent parotidectomy in the management of advanced head and neck non-melanoma skin cancer (hnNMSC). The aim of this study was to identify prognostic factors associated with worse outcomes. Forty-one men and nine women were included. The mean age at the time of surgery was 78.9 years. The 5-year overall survival, disease-specific survival, locoregional recurrence-free survival, and distant metastasis-free survival calculated with Kaplan–Meier curves were 39.9%, 56.3%, 58.6%, and 82.1%, respectively. A univariate analysis showed that the status of the margins, facial nerve direct involvement, lymph vascular invasion, and histological grading were associated with worse outcomes (p < 0.05). Positive margins were associated with worse disease-specific survival also in a multivariate analysis (p = 0.001, HR = 32.02, and CIs 4.338 to 351.3). Because the resection in free margins is the most important prognostic factor, early diagnosis or, in the case of advanced disease, extensive surgical resection with concomitant reconstruction is needed. Adjuvant therapy is indicated in selected cases.

Publisher

MDPI AG

Reference64 articles.

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