Clinicopathological analysis of salivary gland carcinomas and literature review

Abstract

Malignant salivary gland tumors are rare and exhibit a broad spectrum of phenotypic heterogeneity. The objective of this study was to investigate prognostic factors in patients with salivary gland carcinomas and review the results in light of other reports. We retrospectively reviewed 40 patients with primary salivary gland carcinomas who were diagnosed and treated at our institution between 1991 and 2014. Of the 40 tumors, 19 (47.5%) were mucoepidermoid carcinomas, 11 (27.5%) were adenoid cystic carcinomas, 7 (17.5%) were acinic cell carcinomas, 2 (5.0%) were myoepithelial carcinomas and 1 (2.5%) was a squamous cell carcinoma. Clinically positive lymph nodes were present in 4 patients (10.0%). As regards clinical stage, 15 cases (37.5%) were stage I, 13 (32.5%) were stage II, 1 (2.5%) was stage III and 11 (27.5%) were stage IVA. The majority of the patients (97.5%) were treated with surgery, of whom 25 (62.5%) received surgery alone and 14 (35.0%) underwent surgery in combination with chemotherapy or chemotherapy and radiotherapy. The median follow-up time for all the patients was 48 months. The disease-specific survival rate at 5 years was 87.1%. We identified a significant correlation between poor survival rate and histological grade (intermediate/high), tumor size (T3/T4), lymph node metastasis (node-positive) and clinical stage (III/IV) using the Kaplan-Meier method (P<0.05 for each). In addition, the Cox proportional hazards regression analysis confirmed that lymph node metastasis and tumor size were independent prognostic factors for disease-specific survival (hazard ratio = 18.7 and 15.1, respectively; P=0.023 and 0.037, respectively). Furthermore, tumor size was found to be a predictive factor regarding recurrence in the multivariate logistic regression analysis (odds ratio = 8.35; P=0.025). Our results suggest that lymph node metastasis and tumor size are significant prognostic factors for patients with salivary gland carcinomas.

Is DOG1 really useful in the diagnosis of salivary gland acinic cell carcinoma? - A DOG1 (clone K9) analysis in fine needle aspiration cell blocks and the review of the literature

“…[ 1 ] Fortuitously, primary salivary gland carcinomas are rare accounting for approximately 0.5% of all malignancies and lesser than 5% of all head and neck cancers. [ 2 12 ] However, 24 different malignant subtypes of salivary gland carcinomas endorsed by the World Health Organization blue book 2005 with a broad tumor heterogeneity, clinical outcome, and varying prognoses. [ 12 13 ] Surgical excision is the first step and benign tumors needed to be distinguished from the malignant ones to set up the correct surgical management.…”

Malignant sublingual gland tumors: demographics, prognostic factors, and treatment outcomes

“…Furthermore, a higher stage has been shown to be a predictive factor for recurrence in salivary gland carcinomas. 32 Tumor recurrence has been shown to significantly decrease survival in sublingual gland tumors. 12 In previous literature, sublingual gland tumors have been reported to typically present at an advanced stage because they generally manifest as asymptomatic swellings in the floor of the mouth and are often clinically misdiagnosed as a cyst or benign tumor.…”

“…11.0% of the tumors were low grade,32.4% intermediate grade, 16.7% high grade, and 40.0% were unknown grade. The stage at presentation for the entire population was 17.1% for stage I, 14.8% for stage II, 17.6% for stage III, 11.4% for stage IV, and 39.0% were unknown.…”

Outcomes of Primary Squamous Cell Carcinoma of Major Salivary Glands Treated by Surgery With or Without Postoperative Radiotherapy

“…[1][2][3][4] A painless progressive mass was the most common symptom. 5 If primary SCC is not treated early and effectively, it often advances rapidly and results in high morbidity and mortality. 6,7 Owing to the low incidence of primary SCC, it is often discussed together with other histologic malignancies or metastatic SCC of the major salivary glands.…”