Clinical Applicability
The high levels of recurrence have guided us to adopt aggressive initial approach: Partial Parotidectomy to P0 patients and Total Parotidectomy to P1-3 patients; once the survival was poor in the P1-P3 patients and there is not a difference in recurrence and survival between types of parotidectomy; at same time we lowering the facial nerve complications in P0 stages.
We also suggest the selective (I-III) neck dissection in all cases in order to achieve prolonged survival since it is difficult to “wait and see” the neck.