title: The Prognostic Significance of Facial Nerve Involvement in Carcinomas of the Parotid Gland.
abstract: Facial nerve (FN) palsy and perineural invasion (PNI) are adverse features in carcinomas of the parotid gland. FN sacrifice at the time of surgery is associated with significant morbidity. The role of adjuvant radiotherapy in patients with high-risk features, including FN involvement, remains unclear.
  
  
  OBJECTIVE
  Analyze the disease-free survival (DFS) and overall survival (OS) and the impact of tumor characteristics, including FN involvement, for patients treated with surgical resection for carcinoma of the parotid gland.
  
  
  METHODS
  This is a retrospective chart review.
  
  
  METHODS
  University of Utah and Intermountain Healthcare, Utah.
  
  
  METHODS
  A total of 129 patients who were treated with primary surgery for nonmetastatic primary malignancies of the parotid gland from 1988 to 2006.
  
  
  METHODS
  Parotidectomy with or without adjuvant therapy.
  
  
  METHODS
  Kaplan-Meier analysis was used to obtain 5-year estimates of DFS and OS. Recurrence risk factors, particularly the impact of FN involvement, were analyzed.
  
  
  RESULTS
  Five-year DFS and OS rates were 79% and 78%, respectively. Thirty-two (28%) patients developed recurrent disease. Disease recurrence occurred in 64% of patients with both FN palsy and PNI, in 43% with FN palsy without PNI, in 27% with only PNI, and in 16% without either feature.
  
  
  CONCLUSIONS
  FN involvement, particularly FN palsy, is a predictor of increased risk of recurrence and death. Radiotherapy cannot substitute for FN sacrifice in high-risk patients.
authors.affiliation: Departments of *Radiation Oncology †Otolaryngology-Head and Neck Surgery, University of Utah Huntsman Cancer Hospital, Salt Lake City ‡Department of Radiation Oncology, Intermountain Medical Center, Murray, UT §Department of Radiation Oncology, University of Vermont, Burlington, VT.
authors.forename: Breanne E
authors.initials: BE
authors.lastname: Terakedis
authors.forename: Jason P
authors.initials: JP
authors.lastname: Hunt
authors.forename: Luke O
authors.initials: LO
authors.lastname: Buchmann
authors.forename: Vilija N
authors.initials: VN
authors.lastname: Avizonis
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Anker
authors.forename: Ying J
authors.initials: YJ
authors.lastname: Hitchcock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020330:Bell Palsy / Q000209:etiology*; D002277:Carcinoma / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D018572:Disease-Free Survival; D005154:Facial Nerve / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult