Risk factors for subsequent recurrence after surgical treatment of recurrent pleomorphic adenoma of the parotid gland

Background: Recurrent pleomorphic adenoma (PA) can be a lifelong disease, and rates of subsequent recurrence are high. Methods: Patients between 2000 and 2015 were identified. Primary outcome was subsequent recurrence after surgical salvage. Results: Twenty-seven of 84 patients developed a subsequent recurrence. Risk factors for subsequent recurrence included a higher number of previous recurrences (P <.01), worse preoperative facial nerve function (P <.01), and deep parotid lesion(s) (P <.01). Interval since last surgery was protective (P <.01), specifically >10 years since last surgery (P <.01). For patients with a >10-year interval since their last surgery, the subsequent recurrence-free rate at 10 years follow-up was 80.2% vs 31.8%. Conclusions: For patients presenting with a >10-year interval since their last surgery, subsequent recurrence rates are low, which may allow for as needed surveillance recommendations. For patients presenting with recurrent PA and ≤10 years since their last surgery, a closer surveillance is warranted.