Malignant parotid tumors: Natural history and treatment

Abstract

Sixty-seven cases of histologically proven malignant parotid tumors are presented. Forty percent of the tumors were differentiated adenocarcinoma, while malignant mixed tumors (or pleomorphic adenocarcinomas) formed 18%. The remaining types of malignant salivary tumors are also represented in the series. The natural history and spread of these tumors are studied in detail, with lymph-node metastasis occurring in 25% of the cases and distant metastasis in 20%. Malignant tumors involve largely the retromandibular portion of the parotid gland in over 40% of the cases and the preauricular portion in about one-fifth of the cases. Both regions are affected in a further fifth of the cases. A combination of surgery and radiotherapy was the method employed for curative therapy, with radiotherapy alone reserved mainly for palliation. While the overall five-year survival was 42%, late recurrences constitute a serious problem with eventual demise of about half of these patients. Various factors affecting the prognosis, including histological type of tumor, method of treatment and response to radiotherapy are discussed. Cancer 40:136–144, 1977.