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Diagnosis and Management of Parotid Gland Cancer with Focus on the Role of Preoperative Fine-Needle Aspiration Cytology: A 10-Year-Long Retrospective Study with 5-Year Follow-Up

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Abstract

Introduction

Salivary gland cancers represent a rare heterogeneous group of neoplasms with complex clinicopathological characteristics and distinct biological behaviour. The appropriate diagnosis and management of parotid gland cancer are challenging and should be based on the clinical, imaging, cytological, and histological features. The present study analysed the use of preoperative fine-needle aspiration cytology (FNAC) and intraoperative frozen section (FS) to guide the appropriate surgical and postoperative treatment of parotid gland cancers.

Materials and Methods

We selected 48 patients with primary malignancy of the parotid gland surgically treated between 1 January 2008 and 30 June 2017 at the Maxillo-Facial Surgery Division, University Hospital of Parma, Italy. The patients had postoperative histological diagnosis of malignant parotid cancer and were followed up for longer than 5 years.

Results

The 48 patients included in this study had a mean age of 56.7 years. The most frequent type of parotid gland cancer was carcinoma ex pleomorphic adenoma (22.9%), followed by mucoepidermoid carcinoma (16.7%) and acinic cell carcinoma (14.6%). All 48 patients underwent preoperative FNAC: 29 (60.4%) and 19 (39.6%) were suggestive of malignant and benign lesions, respectively. In 31 patients, intraoperative FS was performed.

Discussion

Compared to previous studies, the present study showed significantly lower diagnostic sensitivity of FNAC for parotid gland cancers. The preoperative diagnostic accuracy for suspected malignant cases may be improved by repeat analysis of the cytological specimen by experts, preoperative core needle biopsy, and/or intraoperative FS analysis of the suspected mass.

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Funding

The authors did not receive support from any organization for the submitted work. No funds, grants, or other support was received. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Via Gramsci 14, 43100, Parma, Italy

    Andrea Varazzani, Laura Tognin, Michela Bergonzani, Andrea Ferri, Silvano Ferrari & Tito Poli

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  1. Andrea Varazzani
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Correspondence to Andrea Varazzani.

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The study protocol was approved by the Institutional Review Board and Ethics Committee of the University Hospital of Parma. The study was performed in accordance with the Declaration of Helsinki.

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Varazzani, A., Tognin, L., Bergonzani, M. et al. Diagnosis and Management of Parotid Gland Cancer with Focus on the Role of Preoperative Fine-Needle Aspiration Cytology: A 10-Year-Long Retrospective Study with 5-Year Follow-Up. J. Maxillofac. Oral Surg. 22, 373–380 (2023). https://doi.org/10.1007/s12663-023-01849-z

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