Oral diseases · 2025
Recurrent Pleomorphic Adenoma of the Parotid Gland: Proposal for an LMCG Classification System and an Optimized Therapeutic Algorithm.
СтатьяНазвание и аннотация: Перевод в очереди
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Ye Qicheng, Liu Dongrui, Huang Lingli, Zhu Wenya, Lu Hao, Yang Wenjun, Xu Wanlin
Аннотация
OBJECTIVES: To introduce a novel clinical classification system and corresponding therapeutic strategies for parotid recurrent pleomorphic adenoma (RPA).
METHODS: A retrospective analysis was conducted on parotid RPA cases treated by a single surgical team at Shanghai Ninth People's Hospital between January 2020 and December 2024. Based on tumor features-such as single or multiple nodules, infringement of adjacent structures, or skip metastases-as well as intraoperative facial nerve status, a classification system and corresponding treatment strategy were proposed.
RESULTS: A total of 66 patients were included in the study. The majority (95.5%) presented with multinodular tumors, and 66.7% developed facial paralysis due to intraoperative facial nerve injury. The classification system termed "Localized-Moderate-Complicated-General" (LMCG) was first developed. The Localized type represents the least severe condition, while the subsequent categories reflect progressively more complex presentations. Each classification corresponds to a tailored therapeutic strategy, ranging from partial parotidectomy with or without facial nerve preservation to extensive parotidectomy combined with immediate nerve reconstruction and adjuvant radiotherapy.
CONCLUSION: The LMCG classification offers a concise framework for preoperative assessment and personalized treatment planning in patients with parotid RPA, with the potential to standardize and improve its clinical outcomes.
METHODS: A retrospective analysis was conducted on parotid RPA cases treated by a single surgical team at Shanghai Ninth People's Hospital between January 2020 and December 2024. Based on tumor features-such as single or multiple nodules, infringement of adjacent structures, or skip metastases-as well as intraoperative facial nerve status, a classification system and corresponding treatment strategy were proposed.
RESULTS: A total of 66 patients were included in the study. The majority (95.5%) presented with multinodular tumors, and 66.7% developed facial paralysis due to intraoperative facial nerve injury. The classification system termed "Localized-Moderate-Complicated-General" (LMCG) was first developed. The Localized type represents the least severe condition, while the subsequent categories reflect progressively more complex presentations. Each classification corresponds to a tailored therapeutic strategy, ranging from partial parotidectomy with or without facial nerve preservation to extensive parotidectomy combined with immediate nerve reconstruction and adjuvant radiotherapy.
CONCLUSION: The LMCG classification offers a concise framework for preoperative assessment and personalized treatment planning in patients with parotid RPA, with the potential to standardize and improve its clinical outcomes.