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Volume 46, Issue 2 , Pages 323-331, January 2010

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

Elham Jouzdani
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Jacques Yachouh
- Maxillo Facial Surgery, Lapeyronie Hospital, Montpellier University Hospital Center, France
Valérie Costes
- Pathology Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Jean Luc Faillie
- Medical Statistics Department, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, France
César Cartier
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Flora Poizat
- Pathology Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Guillemette Pierre
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Vincent Burcia
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Marc Makeieff
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Louis Crampette
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Bernard Guerrier
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
Renaud Garrel
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
- Corresponding author: Address: Head and Neck Surgery Department, Gui de Chauliac Hospital, Pole of Head and Neck Neurosciences, Montpellier University Hospital Center, France. Tel.: +33 4 67 33 68 03; fax: +33 4 67 33 67 28.

Received 9 September 2009; accepted 9 October 2009. published online 20 November 2009.

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.