Natural history of recurrent pleomorphic adenoma: implications on management

Matthijs H Valstar; Simon Andreasen; Patrick A Bhairosing; Mark McGurk

doi:10.1002/hed.26137

Natural history of recurrent pleomorphic adenoma: implications on management

Matthijs H Valstar, Simon Andreasen, Patrick A Bhairosing, Mark McGurk

Øre-, Næse- og Halskirurgisk Afdeling

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer review

Abstract

BACKGROUND: Treating recurrent pleomorphic adenoma (RPA) aims to reduce risk of malignant transformation (MT) while avoiding facial nerve injury. Our objective was to systematically investigate this natural history of RPA and address the current rational for its treatment.

METHODS: The follow-up data of two nationwide series of PA was pooled with a focus on risk of MT and analyzed against the literature.

RESULTS: The combined nationwide data (n = 9003 PA patients) showed 3.1% with first recurrence of which 6.2% were malignant. In the literature first RPA rate was >7% at 20 years follow-up. MT occurred in 0% to 7%, and facial nerve damage increased from with each surgery 3% to 16% at first RPA to 18% to 30% at second RPA.

CONCLUSIONS: RPA showed a characteristic course with surgery being unreliable and damage to the facial nerve. The risk of MT was low. This might give flexibility towards a more conservative approach of management.

Originalsprog	Engelsk
Sider (fra-til)	2058-2066
Antal sider	9
Tidsskrift	Head and Neck
Vol/bind	42
Udgave nummer	8
Tidlig onlinedato	18 mar. 2020
DOI	https://doi.org/10.1002/hed.26137
Status	Udgivet - aug. 2020

Bibliografisk note

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10.1002/hed.26137

Citationsformater

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title = "Natural history of recurrent pleomorphic adenoma: implications on management",

abstract = "BACKGROUND: Treating recurrent pleomorphic adenoma (RPA) aims to reduce risk of malignant transformation (MT) while avoiding facial nerve injury. Our objective was to systematically investigate this natural history of RPA and address the current rational for its treatment.METHODS: The follow-up data of two nationwide series of PA was pooled with a focus on risk of MT and analyzed against the literature.RESULTS: The combined nationwide data (n = 9003 PA patients) showed 3.1% with first recurrence of which 6.2% were malignant. In the literature first RPA rate was >7% at 20 years follow-up. MT occurred in 0% to 7%, and facial nerve damage increased from with each surgery 3% to 16% at first RPA to 18% to 30% at second RPA.CONCLUSIONS: RPA showed a characteristic course with surgery being unreliable and damage to the facial nerve. The risk of MT was low. This might give flexibility towards a more conservative approach of management.",

keywords = "malignant transformation, pleomorphic adenoma, recurrence, review, treatment",

author = "Valstar, {Matthijs H} and Simon Andreasen and Bhairosing, {Patrick A} and Mark McGurk",

note = "{\textcopyright} 2020 Wiley Periodicals, Inc.",

year = "2020",

month = aug,

doi = "10.1002/hed.26137",

language = "English",

volume = "42",

pages = "2058--2066",

journal = "Head and Neck",

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TY - JOUR

T1 - Natural history of recurrent pleomorphic adenoma

T2 - implications on management

AU - Valstar, Matthijs H

AU - Andreasen, Simon

AU - Bhairosing, Patrick A

AU - McGurk, Mark

PY - 2020/8

Y1 - 2020/8

N2 - BACKGROUND: Treating recurrent pleomorphic adenoma (RPA) aims to reduce risk of malignant transformation (MT) while avoiding facial nerve injury. Our objective was to systematically investigate this natural history of RPA and address the current rational for its treatment.METHODS: The follow-up data of two nationwide series of PA was pooled with a focus on risk of MT and analyzed against the literature.RESULTS: The combined nationwide data (n = 9003 PA patients) showed 3.1% with first recurrence of which 6.2% were malignant. In the literature first RPA rate was >7% at 20 years follow-up. MT occurred in 0% to 7%, and facial nerve damage increased from with each surgery 3% to 16% at first RPA to 18% to 30% at second RPA.CONCLUSIONS: RPA showed a characteristic course with surgery being unreliable and damage to the facial nerve. The risk of MT was low. This might give flexibility towards a more conservative approach of management.

AB - BACKGROUND: Treating recurrent pleomorphic adenoma (RPA) aims to reduce risk of malignant transformation (MT) while avoiding facial nerve injury. Our objective was to systematically investigate this natural history of RPA and address the current rational for its treatment.METHODS: The follow-up data of two nationwide series of PA was pooled with a focus on risk of MT and analyzed against the literature.RESULTS: The combined nationwide data (n = 9003 PA patients) showed 3.1% with first recurrence of which 6.2% were malignant. In the literature first RPA rate was >7% at 20 years follow-up. MT occurred in 0% to 7%, and facial nerve damage increased from with each surgery 3% to 16% at first RPA to 18% to 30% at second RPA.CONCLUSIONS: RPA showed a characteristic course with surgery being unreliable and damage to the facial nerve. The risk of MT was low. This might give flexibility towards a more conservative approach of management.

KW - malignant transformation

KW - pleomorphic adenoma

KW - recurrence

KW - review

KW - treatment

U2 - 10.1002/hed.26137

DO - 10.1002/hed.26137

M3 - Article

C2 - 32187769

SN - 1043-3074

VL - 42

SP - 2058

EP - 2066

JO - Head and Neck

JF - Head and Neck

IS - 8

ER -

Natural history of recurrent pleomorphic adenoma: implications on management

Abstract

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