Purpose: The value of parotidectomy in older patients is unclear. This study presents a decision model to help resolve this question. Materials & methods: A Markov model with Monte Carlo simulation was used to compare outcomes in patients of different ages with pleomorphic adenoma of the parotid gland treated by surgery or surveillance. Results: In 30-year-old patients, surgery conferred a 3.5-year gain in life expectancy whereas in 75-year-olds, it was only 0.74 months. The expected rate of malignant transformation at age 30 years was 6.5% after surgery and 26.5% after surveillance; at age 65, corresponding rates were 0.8% and 10.7%. Sensitivity analysis showed that age was the only parameter that significantly contributed to life expectancy. The benefit of surgery was restricted in older patients. Conclusion: Our Markov decision-analysis model suggests that patients older than 65 years with pleomorphic adenoma have a limited survival advantage with surgery compared to surveillance.
|Journal||American Journal of Otolaryngology - Head and Neck Medicine and Surgery|
|State||Published - 1 May 2021|
- Markov model
- Parotid pleomorphic adenoma