Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
Preoperatively Diagnosed Versus Undiagnosed Major Salivary Gland Cancer: Clinicopathological Characteristics, Treatment Strategies, and Oncological Outcomes.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ahn Dongbin, Califano Joseph, Kwak Jihye, Heo Sung Jae, Lee Kyu-Yup
Аннотация
OBJECTIVE: To evaluate differences in clinicopathological characteristics, treatment strategies, and oncological outcomes between preoperatively diagnosed and undiagnosed major salivary gland cancers (MSGCs).
STUDY DESIGN: Retrospective cohort study.
SETTING: A single tertiary academic hospital.
METHODS: Surgically confirmed MSGCs between 2012 and 2023 were included. The cohort was divided into the diagnosed and undiagnosed groups based on the preoperative diagnosis of MSGC determined by fine-needle aspiration cytology (FNAC) or core-needle biopsy. Clinicopathologic features, surgical strategies, and loco-regional control (LRC) were compared between the groups.
RESULTS: A total of 122 patients were enrolled. Among those, 49 (40.2%) were diagnosed preoperatively, while 73 (59.8%) were undiagnosed. The undiagnosed group had a higher reliance on FNAC (93.2% vs 51.0%, P < .001) and higher proportions of low/intermediate-grade tumors (75% vs 26.5%, P < .001) and mucoepidermoid carcinoma (45.2% vs 18.4%, P < .001). These were verified as independent risk factors for preoperative undiagnosis in multivariate logistic regression analysis. The undiagnosed group was associated with delayed (60 vs 24 days, P < .001) and more limited surgical procedures, including lower frequency of near-total/total parotidectomy (23.3% vs 42.9%, P = .001) and elective neck dissection (26.5% vs 61.6%, P < .001), compared to the diagnosed group. Grade- and stage-matched analysis showed a trend towards worse LRC in the high-grade or advanced-stage undiagnosed MSGCs.
CONCLUSIONS: Preoperatively undiagnosed MSGCs exhibit distinct clinicopathological characteristics, treatment strategies, and oncological outcomes compared to preoperatively diagnosed cases, highlighting the critical role of preoperative diagnosis in the management MSGCs.
STUDY DESIGN: Retrospective cohort study.
SETTING: A single tertiary academic hospital.
METHODS: Surgically confirmed MSGCs between 2012 and 2023 were included. The cohort was divided into the diagnosed and undiagnosed groups based on the preoperative diagnosis of MSGC determined by fine-needle aspiration cytology (FNAC) or core-needle biopsy. Clinicopathologic features, surgical strategies, and loco-regional control (LRC) were compared between the groups.
RESULTS: A total of 122 patients were enrolled. Among those, 49 (40.2%) were diagnosed preoperatively, while 73 (59.8%) were undiagnosed. The undiagnosed group had a higher reliance on FNAC (93.2% vs 51.0%, P < .001) and higher proportions of low/intermediate-grade tumors (75% vs 26.5%, P < .001) and mucoepidermoid carcinoma (45.2% vs 18.4%, P < .001). These were verified as independent risk factors for preoperative undiagnosis in multivariate logistic regression analysis. The undiagnosed group was associated with delayed (60 vs 24 days, P < .001) and more limited surgical procedures, including lower frequency of near-total/total parotidectomy (23.3% vs 42.9%, P = .001) and elective neck dissection (26.5% vs 61.6%, P < .001), compared to the diagnosed group. Grade- and stage-matched analysis showed a trend towards worse LRC in the high-grade or advanced-stage undiagnosed MSGCs.
CONCLUSIONS: Preoperatively undiagnosed MSGCs exhibit distinct clinicopathological characteristics, treatment strategies, and oncological outcomes compared to preoperatively diagnosed cases, highlighting the critical role of preoperative diagnosis in the management MSGCs.