Surgical excision is usually curative. In the parotid, superficial parotidectomy is more likely to result in long term cure, with a 5% risk of long term recurrence. Local excision only results in, at most, a 25% risk of local recurrence.
Radiotherapy is indicated only in the following situations:
- Recurrent disease
- Positive margins
- Surgical resection not possible without significant morbidity
Long term follow up of patients with pleomorphic adenoma treated with radiation shows that after 20 years there is the potential for late recurrence. The risk is low (3%) but often malignant.