title: Prognostic value of a three-grade classification in primary epithelial parotid carcinoma: result of a histological review from a 20-year experience of total parotidectomy with neck dissection in a single institution.
abstract: BACKGROUND
  The tumour grading of primary parotid cancers (PPCs) remains controversial.
  
  
  METHODS
  A 20-year standardised single centre treatment has been assessed retrospectively. The histological review of 155 consecutively treated parotid malignancies identified 96 suitable cases for univariate and multivariate survival analyses.
  
  
  RESULTS
  Treatment involved total parotidectomy, neck dissection and post-operative radiotherapy in, respectively, 91.7%, 83.3% and 70.4% of cases. The 5-year overall survival, disease-specific and recurrence-free survival rates were 79.4%, 83.5% and 70.8%, respectively. Univariate analysis confirmed the classical prognostic factors, i.e. age>60 years, male gender, facial palsy, hardness of the tumour, clinical stage, tumour grade, facial nerve invasion and lymph node metastases. Multivariate analysis identified a three-grade classification just after the clinical stage as the most important prognostic factor.
  
  
  CONCLUSIONS
  This study identifies the prognostic significance of intermediate grade tumours.
authors.affiliation: Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France.
authors.forename: Elham
authors.initials: E
authors.lastname: Jouzdani
authors.forename: Jacques
authors.initials: J
authors.lastname: Yachouh
authors.forename: Valérie
authors.initials: V
authors.lastname: Costes
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Faillie
authors.forename: César
authors.initials: C
authors.lastname: Cartier
authors.forename: Flora
authors.initials: F
authors.lastname: Poizat
authors.forename: Guillemette
authors.initials: G
authors.lastname: Pierre
authors.forename: Vincent
authors.initials: V
authors.lastname: Burcia
authors.forename: Marc
authors.initials: M
authors.lastname: Makeieff
authors.forename: Louis
authors.initials: L
authors.lastname: Crampette
authors.forename: Bernard
authors.initials: B
authors.lastname: Guerrier
authors.forename: Renaud
authors.initials: R
authors.lastname: Garrel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods* / Q000451:nursing*; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult