Role of intraoperative tumour spillage in prognostic outcome of pleomorphic adenoma: A systematic review

Background Pleomorphic adenoma (PA) is the most common neoplasm of salivary gland origin. The exact cause of PA recurrence is ambiguous. Incomplete surgical excision and violation or accidental rupture of tumour capsule are the widely accepted causes. Aim To study intraoperative tumour spillage‐associated recurrence and prognosis in cases of PA of the parotid gland. Materials and Methods A systematic literature search was performed to include case series and observational studies discussing about intraoperative tumour spillage and recurrence in PA of the parotid gland. Quality assessment for the included studies cases was performed based on Joanna Briggs Institute checklist. Results A total of 27 studies were included in this review. The majority of the studies reported about cases of intraoperative tumour spillage in PA of the parotid gland. Overall, 12 studies specifically mentioned about the relation of tumour spillage with tumour recurrence. A total of 3 studies observed the association between the mode of treatment and tumour spillage and recurrence. Conclusion Intraoperative tumour spillage is a major factor responsible for PA recurrence. A comprehensive knowledge of the recurrence risk factors is of utmost importance. The results of this systematic review aim to make clinicians and surgeons aware that the capsular status of PA is a principal aspect to be taken care of.