Background
The survival rates and prognostic factors for salivary duct carcinoma (SDC) are not clear.
Methods
Survival estimates and prognostic factors were evaluated for 228 patients with SDC identified from the Surveillance, Epidemiology, and End Results (SEER) database.
Results
Median overall survival (OS) duration for patients with SDC was 79 months and 5-year disease-specific survival (DSS) rate was 64%. Among patients with SDC with lymph node involvement, larger primary tumor size (>3 cm) was associated with twice the risk of death (p < .03). Factors predictive of improved DSS were age (p = .01), tumor size (p = .006), tumor grade (p = .02), and lymph node involvement (p < .001). Adjuvant radiotherapy did not improve survival when compared to surgery alone for early-stage (I–II) disease (p = .28).
Conclusion
Younger patients with SDC (<50 years) showed a better prognosis. Primary tumor size and lymph node involvement were independent and additive risk factors for poor prognosis. The role of adjuvant radiotherapy in the treatment of SDC needs to be explored further.
Objectives
The effect of smoking and human papilloma virus (HPV) on overall survival (OS) of oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing concurrent chemoradiation (CCRT) remains unclear.
Study Design
Retrospective Review
Methods
Clinical characteristics of OPSCC patients treated between 2008– 2015 with CCRT were abstracted from medical records. OS curves and multivariate cox proportional hazard ratios (HR) were examined.
Results
Out of 120 evaluable patients, 71% had HPV+ tumors. Median follow-up duration for the entire cohort was 41.5 months (6–88 months). HPV+ current smokers experienced significantly worse 5 year OS (73% alive vs. 36% alive, p=0.01) with a similar trend in HPV− current smokers (66% alive vs. 31% alive, p=0.28) compared to former/never smokers undergoing CCRT. In a multivariate cox proportional hazard model adjusted for age, gender, and overall tumor stage, HPV+ current smokers experienced nearly a four-fold increase in overall mortality in comparison to HPV+ never/former smokers (HR= 3.68, 95% CI=1.35–10.0). Similarly, current smokers with HPV− tumors (HR= 6.8, 95% CI=1.11–41.67) had increased mortality compared to never/former smokers.
Conclusions
Current smoking is associated with poor prognosis, independent of HPV status, in OPSCC CCRT treated patients. Current smoking produced an approximately 4 to 7 fold increase in risk of mortality for HPV+ and HPV− patients respectively. Regardless of pack-years, efforts should be made to achieve smoking cessation before CCRT regardless of HPV status.
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