Trends in the Extent of Surgical Management for Low-Grade Parotid Malignancies: A SEER Analysis.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-05-21 DOI:10.1002/ohn.1305

Katelyn S Rourk, Gabriela A Calcano, Hawa M Ali, Amy E Glasgow, Elizabeth B Habermann, Daniel L Price, Kendall K Tasche, Kathryn M Van Abel, Eric J Moore, Linda X Yin

{"title":"Trends in the Extent of Surgical Management for Low-Grade Parotid Malignancies: A SEER Analysis.","authors":"Katelyn S Rourk, Gabriela A Calcano, Hawa M Ali, Amy E Glasgow, Elizabeth B Habermann, Daniel L Price, Kendall K Tasche, Kathryn M Van Abel, Eric J Moore, Linda X Yin","doi":"10.1002/ohn.1305","DOIUrl":null,"url":null,"abstract":"Objective: Low-grade parotid malignancies have high overall survival rates; however, controversy remains about the appropriate extent of surgery. We aim to explore the trends in the extent of parotidectomy performed over time in low-grade parotid malignancies in the United States, with a hypothesis that there has been a trend towards less aggressive surgery.Study design: Retrospective cohort study of all low-grade (grade I) acinic cell carcinoma (ACC) and mucoepidermoid carcinoma (MEC) in the Surveillance, Epidemiology, and End Results (SEER) from 2004 to 2020.Setting: Geographic areas served by SEER.Methods: Trends were assessed using Cochran-Armitage tests and logistic regression; Kaplan-Meier survival curves were used to analyze overall and cancer-specific survival, and chi-square tests were used to analyze patient characteristics.Results: In total, 1288 patients were identified (916 MEC; 372 ACC). Most patients (n = 772, 60%) were non-Hispanic white, with an average age of 50.6 years and had a slight female predominance (1.58:1). Most of the cohort presented with tumor stage T1 or T2 (84%), N0 (90.1%), and M0 (96.9%). Treatment with total parotidectomy decreased significantly (34.6 vs 17.7%, P = .02) whereas sacrificing the facial nerve (FN) slightly decreased (20 vs 15.7%, P = .1). A significant increase in N0 patients (71%-94%, P < .0001) was observed, whereas T staging remained stable (61%-64%, P = .3). Overall, both ACC and MEC had excellent cancer-specific survival.Conclusion: Over the last 17 years, there has been a significant de-escalation in the extent of parotidectomy for low-grade parotid malignancy in the United States.","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.1305","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Low-grade parotid malignancies have high overall survival rates; however, controversy remains about the appropriate extent of surgery. We aim to explore the trends in the extent of parotidectomy performed over time in low-grade parotid malignancies in the United States, with a hypothesis that there has been a trend towards less aggressive surgery.

Study design: Retrospective cohort study of all low-grade (grade I) acinic cell carcinoma (ACC) and mucoepidermoid carcinoma (MEC) in the Surveillance, Epidemiology, and End Results (SEER) from 2004 to 2020.

Setting: Geographic areas served by SEER.

Methods: Trends were assessed using Cochran-Armitage tests and logistic regression; Kaplan-Meier survival curves were used to analyze overall and cancer-specific survival, and chi-square tests were used to analyze patient characteristics.

Results: In total, 1288 patients were identified (916 MEC; 372 ACC). Most patients (n = 772, 60%) were non-Hispanic white, with an average age of 50.6 years and had a slight female predominance (1.58:1). Most of the cohort presented with tumor stage T1 or T2 (84%), N0 (90.1%), and M0 (96.9%). Treatment with total parotidectomy decreased significantly (34.6 vs 17.7%, P = .02) whereas sacrificing the facial nerve (FN) slightly decreased (20 vs 15.7%, P = .1). A significant increase in N0 patients (71%-94%, P < .0001) was observed, whereas T staging remained stable (61%-64%, P = .3). Overall, both ACC and MEC had excellent cancer-specific survival.

Conclusion: Over the last 17 years, there has been a significant de-escalation in the extent of parotidectomy for low-grade parotid malignancy in the United States.

查看原文本刊更多论文

低级别腮腺恶性肿瘤手术治疗范围的趋势：一项SEER分析。

目的：低级别腮腺恶性肿瘤总生存率高；然而，关于手术的适当程度仍然存在争议。我们的目的是探讨在美国低级别腮腺恶性肿瘤中，随着时间的推移，腮腺切除术的程度的趋势，假设有一种趋向于低侵袭性手术的趋势。研究设计：2004年至2020年所有低级别（I级）腺泡细胞癌（ACC）和粘液表皮样癌（MEC）的监测、流行病学和最终结果（SEER）回顾性队列研究。设置：SEER服务的地理区域。方法：采用Cochran-Armitage检验和logistic回归评估趋势；Kaplan-Meier生存曲线用于分析总体生存和癌症特异性生存，卡方检验用于分析患者特征。结果：共发现1288例患者(916例MEC；372年ACC)。大多数患者（n = 772, 60%）为非西班牙裔白人，平均年龄50.6岁，女性略有优势（1.58:1）。大多数队列的肿瘤分期为T1或T2 (84%), N0（90.1%）和M0（96.9%）。腮腺全切除术治疗显著减少（34.6 vs 17.7%, P = 0.02），而牺牲面神经（FN）治疗略有减少（20 vs 15.7%, P = 0.1）。结论：在过去的17年里，在美国，低级别腮腺恶性肿瘤的腮腺切除术的程度有了显著的降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.