Malignant tumors of the parotid gland in children: incidence and outcomes

J Craniofac Surg. 2013 Sep;24(5):1660-4. doi: 10.1097/SCS.0b013e3182997d52.

Abstract

Background: Population-based analysis of the incidence, demographics, and management outcomes in children with malignant tumors of the parotid gland.

Methods: Surveillance, Epidemiology, and End Results database (1973-2009) was researched for all patients younger than 20 years.

Results: Overall, 284 patients were identified. Annual incidence of these tumors was 1.43 cases per million. The highest incidence occurred in girls (0.86/1,000,000), black children (0.849/1,000,000), and adolescents (1.56/1,000,000). Median age at diagnosis was 13.5 years. Most patients were 10 years or older (n = 256, 90%). Most patients presented with local disease (n = 207, 76%). Only 3% had metastasis at time of diagnosis. Most tumors were mucoepidermoid carcinomas (n = 139, 49%) or acinar cell carcinomas (n = 113, 40%). There were no differences in survival between mucoepidermoid and acinar cell carcinomas (96% vs 98% respectively, P = 0.317). Overall mortality was 4.6% over the study period. Overall survival was 96% at 5 years, 95% at 10 years, and 83% at 20 years. Adolescents had significantly higher mortality rates (7.1% vs 1.6% for children <15 years of age, P = 0.23). Multivariate analysis identified the use of adjuvant radiation therapy (hazard ratio, 6.01; 95% confidence interval, 1.15-31.45; P = 0.034) as the only independent predictor of poor outcome.

Conclusions: Malignant parotid gland tumors are most common in adolescents, and this subgroup has worse outcomes. The role of radiotherapy remains controversial.

MeSH terms

  • Adolescent
  • Age Distribution
  • Carcinoma, Acinar Cell / epidemiology*
  • Carcinoma, Acinar Cell / pathology
  • Carcinoma, Mucoepidermoid / epidemiology*
  • Carcinoma, Mucoepidermoid / pathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Male
  • Multivariate Analysis
  • Parotid Neoplasms / epidemiology*
  • Parotid Neoplasms / pathology
  • Sex Distribution
  • Survival Analysis