title: Recurrent cancer of the parotid gland: how well does salvage surgery work for locoregional failure?
abstract: OBJECTIVE
  Many articles have discussed the clinical features of previously untreated parotid cancer, but the clinical characteristics and treatment of recurrent parotid cancer have not yet been fully described.
  
  
  METHODS
  We retrospectively reviewed 20 patients with recurrent parotid cancer and analyzed the therapeutic strategies and the prognostic factors.
  
  
  RESULTS
  Twelve patients (60%) underwent definitive surgery, including 3 who underwent skull base surgery. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) in the surgery group were 66.7 and 64.1%. In the definitive surgery group, the presence of lymph node metastasis and high-grade malignant histopathology were associated with a poor prognosis (p < 0.01). On the other hand, the presence of facial palsy at presentation, the surgical margin, the time of relapse and the T stage did not affect the DFS in our series.
  
  
  CONCLUSIONS
  The results suggest that aggressive definitive surgery may be justified for the treatment of recurrent parotid cancer. The presence of lymph node metastasis and the histopathological malignancy grade are poor prognostic factors for OS and DFS.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. kenyajp@hotmail.com
authors.forename: Kenya
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Nakao
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Mizuo
authors.initials: M
authors.lastname: Ando
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ebihara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakage
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery; D018249:Adenoma, Oxyphilic / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D018277:Carcinoma, Mucoepidermoid / Q000401:mortality / Q000556:secondary / Q000601:surgery; D005158:Facial Paralysis / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000556:secondary / Q000601:surgery; D010307:Parotid Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000401:mortality; D019291:Skull Base / Q000601:surgery