Page 46 - New epidemiological and PSMA-expression based paradigms in salivary gland tumors
P. 46
Chapter 3
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 pleomorphic adenoma was pooled with a focus on risk of MT and analyzed against the literature.
Results: The combined nationwide data (n=9,003 PA patients) showed 3.1% with 1st recurrence of which 6.2% were malignant. In the literature 1st RPA rate was >7% at 20 years follow-up. MT occurred in 0-7%, and facial nerve damage increased from with each surgery 3-16% at 1st RPA to 18-30% at 2nd 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.
44
