Recurrent Pleomorphic Adenoma of the Parotid Gland: Proposal for an LMCG Classification System and an Optimized Therapeutic Algorithm.

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral diseases Pub Date : 2025-07-04 DOI:10.1111/odi.70022

Qicheng Ye, Dongrui Liu, Lingli Huang, Wenya Zhu, Hao Lu, Wenjun Yang, Wanlin Xu

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引用次数: 0

Abstract

Objectives: To introduce a novel clinical classification system and corresponding therapeutic strategies for parotid recurrent pleomorphic adenoma (RPA).

Methods: A retrospective analysis was conducted on parotid RPA cases treated by a single surgical team at Shanghai Ninth People's Hospital between January 2020 and December 2024. Based on tumor features-such as single or multiple nodules, infringement of adjacent structures, or skip metastases-as well as intraoperative facial nerve status, a classification system and corresponding treatment strategy were proposed.

Results: A total of 66 patients were included in the study. The majority (95.5%) presented with multinodular tumors, and 66.7% developed facial paralysis due to intraoperative facial nerve injury. The classification system termed "Localized-Moderate-Complicated-General" (LMCG) was first developed. The Localized type represents the least severe condition, while the subsequent categories reflect progressively more complex presentations. Each classification corresponds to a tailored therapeutic strategy, ranging from partial parotidectomy with or without facial nerve preservation to extensive parotidectomy combined with immediate nerve reconstruction and adjuvant radiotherapy.

Conclusion: The LMCG classification offers a concise framework for preoperative assessment and personalized treatment planning in patients with parotid RPA, with the potential to standardize and improve its clinical outcomes.

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复发性腮腺多形性腺瘤：LMCG分类系统和优化治疗算法的建议。

目的：介绍一种新的腮腺复发性多形性腺瘤（RPA）的临床分型体系及相应的治疗策略。方法：回顾性分析2020年1月至2024年12月上海第九人民医院单一外科团队治疗的腮腺RPA病例。根据单发或多发结节、侵犯邻近结构、跳跃性转移等肿瘤特征，以及术中面神经状态，提出分类体系及相应的治疗策略。结果：共纳入66例患者。绝大多数（95.5%）表现为多结节性肿瘤，66.7%因术中面神经损伤而发生面瘫。“局部-中等-复杂-一般”（LMCG）分类系统首先被开发出来。本地化类型表示最不严重的情况，而随后的类别反映了越来越复杂的表示。每个分类对应于量身定制的治疗策略，从部分腮腺切除术（保留或不保留面神经）到广泛腮腺切除术联合立即神经重建和辅助放疗。结论：LMCG分类为腮腺RPA患者的术前评估和个性化治疗计划提供了一个简明的框架，具有规范和改善其临床结果的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.