title: Parotid carcinoma: impact of clinical factors on prognosis in a histologically revised series.
abstract: OBJECTIVE
  To analyze clinical data and possible prognostic factors of patients with primary carcinoma of the parotid gland.
  
  
  METHODS
  A retrospective study was made of 85 patients with suspected parotid cancer who were admitted to the Center of Head and Neck Oncology at Odense University Hospital (Odense, Denmark) from 1975 to 1994.
  
  
  METHODS
  Patient records were retrospectively reviewed and tabulated for relevant clinical parameters. A complete revision of histological examination was performed by the same pathologist and the tumors were classified according to the 1991 international guidelines from the World Health Organization. Five tumors (6%) did not fulfill the criteria of malignancy and were reclassified as benign. In another five cases the assumed primary parotid carcinomas were found to be metastatic disease from cancers of the breast, prostate, skin, and lungs. Ten patients (12%) were excluded from the analysis, leaving 75 individuals for the study.
  
  
  RESULTS
  Twenty-four percent of patients were classified as T1, 32% as T2, 15% as T3, and 28% as T4. One patient (1%) was not classifiable (TX). Regional lymph node metastases were found in 17 cases (23%). Two of these were classified as N1 (3%), 2 as N2A (3%) and 13 as N2B (17%). Four patients were registered as not classifiable (NX) (5%). No patients were classified as N3. Distant metastases were found in four patients (5%) (one patient had bone and liver metastases and three patients had lung metastases). Five-year recurrence-free survival of the entire study group was 63%, disease-specific survival was 69%, and crude survival was 52%. In univariate analysis, tumor size, histological appearance, T status, stage, the presence of lymph node metastases, distant metastases, pain, and facial nerve dysfunction had a significant influence on survival.
  
  
  CONCLUSIONS
  A thorough histological revision is pivotal in retrospective parotid carcinoma studies, and tumor size; histological appearance; T, N, and M status; stage; facial nerve dysfunction; and pain from the face and/or neck seem to be significant prognostic indicators for patients with primary parotid carcinoma.
authors.affiliation: Department of Otolarynology-Head and Neck Surgery, Odense University Hospital, Denmark. godballe@dsa-net.dk
authors.forename: Christian
authors.initials: C
authors.lastname: Godballe
authors.forename: Joyce H
authors.initials: JH
authors.lastname: Schultz
authors.forename: Annelise
authors.initials: A
authors.lastname: Krogdahl
authors.forename: Agot
authors.initials: A
authors.lastname: Møller-Grøntved
authors.forename: Jørgen
authors.initials: J
authors.lastname: Johansen
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000556:secondary; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate