title: Clinical history, prognostic factors, and management of facial nerve in malignant tumors of the parotid gland.
abstract: OBJECTIVE
  We analyzed the outcomes following clinical management of parotid masses that were determined to be malignant tumors after parotidectomy.
  
  
  METHODS
  We evaluated data from 70 patients with parotid malignancies between November 1994 and December 2005.
  
  
  RESULTS
  Among salivary histotypes (n=49), the most significant prognostic parameter was cT4 stage at diagnosis (P=0.0055, log-rank) both for clinical involvement of the facial nerve and for invasion of other structures. The main cause of cancer-related death was a distant metastasis.
  
  
  CONCLUSIONS
  The present series confirms that the main prognostic parameter in salivary parotid malignancies was cT4 classification at diagnosis, often due to clinical involvement of the facial nerve. The oncological outcome of salivary malignancies was influenced by distant metastasis more than most other head and neck sites. We recommend dissecting and preserving the functioning VIIth cranial nerve during surgery for parotid malignancies.
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bussu
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Rigante
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Giglia
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bastanza
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: De Corso
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Almadori
authors.affiliation: Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paludetti
keywords: Clinical prognostic factors; Facial nerve; Parotid malignancies; Parotidectomy; VII cranial nerve dissection