The study population consisted of 125 males and 112 females. The mean age was 59 years (males 61 years, females 58 years). Follow-up was at least 5 years. The commonest tumor location was the parotid gland (n = 152; 64%), followed by the minor salivary glands (n =46; 19%), the submandibular gland (n =38; 16%) and the sublingual gland (n = 1; 0.4%). The most frequent histological types of SGC were adenoid cystic carcinoma (n =65; 27%), mucoepidermoid carcinoma (n =45; 19%) and acinic cell carcinoma (n =41; 17%). Surgery, either alone or in combination with other treatment modalities, was used in 209 cases (88%). Radiotherapy was given to 136 patients (57%), 13 of whom (5%) did not undergo surgery. The 5-year overall survival rate was 56.5%, and for stages I-IV it was 78%, 25%, 21% and 23%, respectively (p <0.001; log-rank test). Of the commonest tumor types, the best 5-year relative survival rate was for patients with acinic cell carcinoma (96%), followed by those with mucoepidermoid (79%) and adenoid cystic carcinoma (74%).
The proliferative capacity of a tumor as measured by Ki-67 nuclear antigen is one of the most powerful indicators of tumor behavior. Ki-67 is considered a useful tool in determining the aggressiveness of malignant neoplasms. p53 tumor suppressor gene mutations have been linked with the development and progression of a number of various cancer types. p53 tumor suppressor protein and the volume corrected index of Ki-67 corresponding to Ki-67 /mm2 of tumor tissue (VCI Ki-67) in salivary gland tumors were evaluated by immunohistochemistry from paraffin embedded sections in a series of 212 patients. The follow-up time in this nationwide full population-based study was up to five years. The association of clinicopathological features and the results of present study with survival were examined. In multivariate analysis high VCI Ki-67 was associated with worse survival of SGC patients (p = 0.0114). Supplementary information was brought by age (p = 0.0002), lymph node status (p = 0.0014), gender (p = 0.0017) and stage (p = 0.0191). p53 expression did not have additional value in prediction of survival (p = 0.1433) compared to the commonly clinical used parameters. In this material consisting of various salivary gland carcinomas VCI Ki-67 was a good prognostic factor for survival.
High MMP-13 staining intensity predicted poor survival (3 vs 1; p=0.08) in the whole material studied. High MMP-13 intensity (2+3 vs 1; p=0.05), percentage (2 vs 1; p=0.03) and index (3 vs 1; p=0.02) were associated with poor survival in acinic cell carcinoma. However, high MMP-9 index in adenoid cystic carcinoma (p=0.06) and the percentage of positively staining cells in salivary duct carcinoma patients (p=0.05) was associated with poor survival. High MMP-1 staining intensity (2 vs 0; p=0.06) and index (% x intensity); (2 vs 1, p=0.04) were associated with better overall survival in the whole material.
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