이하선 천엽에 국한된 이하선암종 치료로서의 이하선 천엽절제술과 전 이하선절제술과의 비교

Abstract

Background and Objectives：Although there is little consensus regarding the extent of surgical ablation needed to attain cure in parotid cancers, most surgeons has been used to perform total parotidectomy. However, the chance of development for postoperative facial palsy may be incresed in case of total parotidectomy. The aim of this study was to determine whether superficial parotidectomy (SP) yielded local control and resulted in overall survival rates that are comparable to those of total parotidectomy (TP).

Materials and Method：The medical records of 82 patients who were treated at the Severance Hospital from 1991 to 2000 and diagnosed with the parotid cancers confined to the superficial lobe and had parotidectomy were reviewed. There were 42 males and 40 females, ranging in age from 8 to 84 years. There were 47 patients in group 1 (SP) and 35 in group 2 (TP). 52 patients underwent neck dissection simultaneously with primary lesion. Surgical treatment was followed by radiotherapy in 48 patients. The follow-up period ranged from 2 to 132 months with the mean of 37.7months. Data were analyzed using the Kaplan-Meier method and Log-Rank test and Fisher's exact test.

Results：The clinical prognostic factors of SP group and TP group were not significantly associated with the following variables：histologic grade, tumor size, surgical margin, facial nerve involvement and postoperative radiotherapy. The overall crude 2- and 5- survival rates for the SP group were 87% and 79%, respectively, and those for the TP group were 80.5% and 64.9% (p>0.05), respectively. Also, there was no statistically significant difference in the locoregional recurrence between the SP group and TP group (p>0.05). However, there was statistically significant difference in the presence of postoperative facial palsy between two groups (p<0.05).

Therefore, in terms of oncologic integrity, superficial parotidectomy may be a safe procedure without potential morbidity, such as postoperative facial palsy in the treatment of parotid cancer confined to the superficial lobe.