Helena Levyn, Tejas Subramanian, Alana Eagan, Daniel W Scholfield, Joseph Lopez, Nora Katabi, Richard J Wong, Jatin P Shah, Babak Givi, Luc G T Morris, Ian Ganly, Snehal G Patel
{"title":"腮腺多形性腺瘤的主动监测--肿瘤生长率、潜在恶性程度和手术机会。","authors":"Helena Levyn, Tejas Subramanian, Alana Eagan, Daniel W Scholfield, Joseph Lopez, Nora Katabi, Richard J Wong, Jatin P Shah, Babak Givi, Luc G T Morris, Ian Ganly, Snehal G Patel","doi":"10.1002/jso.27977","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The outcomes of active surveillance (AS) for pleomorphic adenomas (PA) as an alternative to upfront parotidectomy have not been previously documented in the literature. This cohort study aims to assess the safety and feasibility of AS for parotid gland PA.</p><p><strong>Methods: </strong>All patients with of previously untreated PA managed between 1990 and 2015 were reviewed. Patients who underwent AS for a minimum of 1 year from the initial consultation were identified. Patient demographics, the reason for AS, tumor growth rate, indication for surgery in those patients eventually operated, final pathology, and surgical sequelae were analyzed.</p><p><strong>Results: </strong>During the study period, 610 patients with primary PA were treated in our institution. Of whom, 14 (2.3%) underwent AS for a period between 1 and 10 years with a median of 3.73 years (interquartile range [IQR] 1.3-4.9). Patient comorbidities were the most common reason for opting for AS (n = 6, 43%), followed by patients' preference to delay surgery (n = 4, 29%) and older age (n = 2, 14%). The median growth rate was 0.58 mm/year (IQR 0.04, 3.8, range -5.01 to 4.98 mm/year). In patients who eventually underwent parotidectomy (n = 10, 71.4%), the most common reason for intervention was tumor growth (8/10, 80%). Two patients had postsurgical mild transient facial nerve paresis with full recovery, and no carcinomas were discovered on final pathology.</p><p><strong>Conclusion: </strong>In this selected cohort of patients with PA, the tumor growth rate was lower than traditionally believed. Patients who eventually underwent surgery did not suffer from serious complications and there was no evidence of clinical or pathological malignancy.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Active Surveillance for Pleomorphic Adenomas of the Parotid-Tumor Growth Rate, Potential Malignancy, and Surgical Sequalae.\",\"authors\":\"Helena Levyn, Tejas Subramanian, Alana Eagan, Daniel W Scholfield, Joseph Lopez, Nora Katabi, Richard J Wong, Jatin P Shah, Babak Givi, Luc G T Morris, Ian Ganly, Snehal G Patel\",\"doi\":\"10.1002/jso.27977\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The outcomes of active surveillance (AS) for pleomorphic adenomas (PA) as an alternative to upfront parotidectomy have not been previously documented in the literature. This cohort study aims to assess the safety and feasibility of AS for parotid gland PA.</p><p><strong>Methods: </strong>All patients with of previously untreated PA managed between 1990 and 2015 were reviewed. Patients who underwent AS for a minimum of 1 year from the initial consultation were identified. Patient demographics, the reason for AS, tumor growth rate, indication for surgery in those patients eventually operated, final pathology, and surgical sequelae were analyzed.</p><p><strong>Results: </strong>During the study period, 610 patients with primary PA were treated in our institution. Of whom, 14 (2.3%) underwent AS for a period between 1 and 10 years with a median of 3.73 years (interquartile range [IQR] 1.3-4.9). Patient comorbidities were the most common reason for opting for AS (n = 6, 43%), followed by patients' preference to delay surgery (n = 4, 29%) and older age (n = 2, 14%). The median growth rate was 0.58 mm/year (IQR 0.04, 3.8, range -5.01 to 4.98 mm/year). In patients who eventually underwent parotidectomy (n = 10, 71.4%), the most common reason for intervention was tumor growth (8/10, 80%). Two patients had postsurgical mild transient facial nerve paresis with full recovery, and no carcinomas were discovered on final pathology.</p><p><strong>Conclusion: </strong>In this selected cohort of patients with PA, the tumor growth rate was lower than traditionally believed. Patients who eventually underwent surgery did not suffer from serious complications and there was no evidence of clinical or pathological malignancy.</p>\",\"PeriodicalId\":17111,\"journal\":{\"name\":\"Journal of Surgical Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Surgical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jso.27977\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.27977","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:作为腮腺切除术的替代方案,主动监测(AS)治疗多形性腺瘤(PA)的效果尚未见文献记载。这项队列研究旨在评估腮腺多形性腺瘤主动监测的安全性和可行性:方法:对1990年至2015年间接受治疗的所有既往未经治疗的PA患者进行回顾性研究。方法:对 1990 年至 2015 年间接受治疗的所有既往未治疗过的 PA 患者进行回顾性研究,确定自初诊起接受 AS 治疗至少 1 年的患者。分析了患者的人口统计学特征、接受强直性脊柱炎治疗的原因、肿瘤生长率、最终手术患者的手术指征、最终病理结果以及手术后遗症:研究期间,我院共收治了 610 名原发性 PA 患者。其中,14 人(2.3%)接受了为期 1-10 年的 AS 治疗,中位数为 3.73 年(四分位数间距 [IQR] 1.3-4.9)。患者的并发症是选择 AS 的最常见原因(6 例,43%),其次是患者希望推迟手术(4 例,29%)和年龄较大(2 例,14%)。中位增长率为 0.58 毫米/年(IQR 0.04,3.8,范围-5.01 至 4.98 毫米/年)。在最终接受腮腺切除术的患者中(n = 10,71.4%),最常见的干预原因是肿瘤生长(8/10,80%)。两名患者术后出现轻度一过性面神经麻痹,但已完全恢复,最终病理检查未发现癌变:结论:在这批经过筛选的 PA 患者中,肿瘤生长率低于传统观点。结论:在这批精选的 PA 患者中,肿瘤生长率低于传统观点,最终接受手术的患者没有出现严重并发症,也没有临床或病理恶性证据。
Active Surveillance for Pleomorphic Adenomas of the Parotid-Tumor Growth Rate, Potential Malignancy, and Surgical Sequalae.
Objective: The outcomes of active surveillance (AS) for pleomorphic adenomas (PA) as an alternative to upfront parotidectomy have not been previously documented in the literature. This cohort study aims to assess the safety and feasibility of AS for parotid gland PA.
Methods: All patients with of previously untreated PA managed between 1990 and 2015 were reviewed. Patients who underwent AS for a minimum of 1 year from the initial consultation were identified. Patient demographics, the reason for AS, tumor growth rate, indication for surgery in those patients eventually operated, final pathology, and surgical sequelae were analyzed.
Results: During the study period, 610 patients with primary PA were treated in our institution. Of whom, 14 (2.3%) underwent AS for a period between 1 and 10 years with a median of 3.73 years (interquartile range [IQR] 1.3-4.9). Patient comorbidities were the most common reason for opting for AS (n = 6, 43%), followed by patients' preference to delay surgery (n = 4, 29%) and older age (n = 2, 14%). The median growth rate was 0.58 mm/year (IQR 0.04, 3.8, range -5.01 to 4.98 mm/year). In patients who eventually underwent parotidectomy (n = 10, 71.4%), the most common reason for intervention was tumor growth (8/10, 80%). Two patients had postsurgical mild transient facial nerve paresis with full recovery, and no carcinomas were discovered on final pathology.
Conclusion: In this selected cohort of patients with PA, the tumor growth rate was lower than traditionally believed. Patients who eventually underwent surgery did not suffer from serious complications and there was no evidence of clinical or pathological malignancy.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.