Pain on presentation linked to poor prognosis in parotid gland malignancy, Study reveals

The study is published in the Laryngoscope Journal.

Mucoepidermoid carcinomas are the most common type of salivary gland cancer. Most start in the parotid glands. They develop less often in the submandibular glands or in minor salivary glands inside the mouth. These cancers are usually low grade, but they can also be intermediate or high grade.

Sophia Colevas and colleagues from the Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A carried out the present study with the objective to better understand the significance of pain as a predictor of disease severity in parotid gland malignancy.

A retrospective chart review of patients treated for primary parotid gland malignancy was performed. Patient records were retrospectively reviewed and relevant clinical parameters were collected. Patients were stratified into low stage (I and II) disease and high stage (III and IV) disease groups to analyze the independent effect of pain at initial presentation on disease recurrence rate and disease-free survival using Kaplan–Meier survival curves and an independent two-sample t-test.

The following results were seen-

a. Of 154 patients evaluated, there were 69 patients in the low stage group and 80 patients in the high stage group.

b. Thirty-seven high stage patients presented with pain.

c. High stage patients with pain were significantly more likely to develop disease recurrence than high stage patients without pain (58.5% [22/37] versus 33.3% [13/39], P = .022).

d. High stage patients with pain also had significantly decreased disease-free survival time compared to high stage patients without pain (P = .027).

Therefore, the authors concluded that "pain on presentation appears to be a poor prognostic factor for patients with parotid gland malignancy. For patients with demonstrated high stage disease, pain is independently associated with increased risk of recurrence and decreased disease-free survival time."