2025 Proffered Presentations
S109: THE ROLE OF EN-BLOC TEMPORO-PAROTID RESECTIONS FOR LOCALLY ADVANCED PAROTID GLAND MALIGNANCIES: PRELIMINARY ANALYSIS
Diego Cazzador; Tiziana Mondello; Giulia Tealdo; Marco Ferrari; Antonio Mazzoni; Piero Nicolai; Elisabetta Zanoletti; Otorhinolaryngology Unit - University of Padova
Introduction: Advanced parotid tumors are often burdened by local recurrence or positive margins due to potential invasion of the temporal bone. En-bloc temporo-parotid resection (TPR) represents a posterior-to-anterior surgical approach from temporal bone to parotid, proposed to obtain clear margins and avoid tumor spillage. The purpose of this study is to analyze survival and prognostic factors of TPR for patients diagnosed with locally-advanced parotid malignancies.
Material & Methods: Data of patients submitted to TPR for locally-advanced parotid tumors between 2016-2023 were retrospectively analyzed. En-bloc TPR extension was preoperatively established on MRI/TC scans. In TPR, the resection borders within soft tissues and the osteotomies run along clear planes, as to embed the tumor itself within non-neoplastic tissues. Kaplan-Meier estimator defined disease-specific survival (DSS). Cox-regression model calculated hazard ratios (HR).
Results: Twenty-six patients (21 males [80.8%]) were included (median age 72 years). Eighteen (69.2%) presented a primary parotid tumor. The most frequent histopathological finding was SCC (10, 38.4%), 6 of which were metastasis from cutaneous malignancies. Free margins were obtained in 21 cases (80.8%). At 21-month median follow-up (range 3-59), 16 patients (61.5%) had no evidence of disease, 7 (26.9%) died of disease, 2 (7.7%) are alive with pulmonary metastases, and one (3.8%) died of other causes. Local recurrence rate was 8%. Two-year DSS was 73.0%. Patients with SCC had a 10-fold risk of lower DSS than non-SCC tumors (HR=10.34, p=0.014).
Conclusions: TPR allows en-bloc removal of locally-advanced parotid tumors that infiltrate temporal bone, with low local-recurrence rates and favorable survival. Longer follow-up is needed to validate the results.