A 10-year review of primary major salivary gland cancers

Abstract

Primary salivary gland cancers comprise a heterogeneous group of histological entities and represent less than 5% of head and neck malignancies. Surgical resection is the main treatment, and adjuvant radiotherapy is performed in selected cases. Chemotherapy is an option in metastatic or recurrent disease, with poor evidence. We aimed to review a 10-year experience of a cancer centre on major salivary gland cancers, focusing on clinical, pathological, treatment and patients' outcomes data. A total of 93 patients were identified, median age at diagnosis was 64 years (IQR, 23), and 51.6% were male. The parotid gland was the site of origin in 76.3% of cases. The most frequent histological type was salivary duct carcinoma (21.5%). All patients were submitted to surgery and adjuvant radiotherapy was performed in 74.2%. From 26 patients diagnosed with metastatic disease, 9 were treated with systemic therapy. At 8 years, disease-free survival was 54.6% and overall survival was 48.4%. Male sex, salivary duct carcinoma, stage pT3-4, stage pN2-3, high histologic grade, lymphovascular invasion and perineural invasion were negative prognostic indicators for disease-free survival and overall survival. Extracapsular spread was a negative prognostic indicator for overall survival. In the multivariable analysis, histological type-salivary duct carcinoma-kept significant negative impact in disease-free survival and high histologic grade in overall survival. The most frequent histological type was salivary duct carcinoma, which is estimated to represent only 9% of salivary tumours. Patients with salivary duct carcinoma relapsed more than other histological types. High histologic grade was a negative prognostic indicator for overall survival.

Predictors of recurrence and disease-free survival for salivary gland tumors among children and young adults in Kampala, Uganda: a retrospective follow-up study

“…Another study which also included children reported DFS of 63% which is lower than the DFS in the present study [23]. Furthermore, three studies which included adult patients with SGTs reported DFS of 54.6% [31] and 69% [32] which were lower than DFS observed in the present study but close to 71% which was reported in the study of Chen et al [4]. Although it has been shown that the survival of children and adolescent patients with SGTs is better than that of adults aged more than 50 years [33], still such relation is not very linear because some discrepancies have been reported.…”

A molecular guide to systemic therapy in salivary gland carcinoma

“…SGCs can be classified into more than 20 subtypes, including mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), salivary duct carcinoma (SDC), acinic cell carcinoma (AciCC), and secretory carcinoma (SC) with widely variable clinical behavior. While each histiotype is individually rare, the group represents approximately 5% of head and neck cancers 3–5 . Surgery and radiation are the mainstays of local SGC therapy, but treatment options for inoperable, recurrent, and metastatic disease have been limited by poor response to cytotoxic chemotherapy 5 .…”

Lymph node ratio‐based prognostic model for risk stratification and individualized adjuvant therapy for postoperative major salivary duct carcinoma

“…MSDC often presents in stage III-IV with lymph node metastasis, and its prognosis is notoriously poor. [9][10][11] Lymph node ratio (LNR), defined as the ratio of the number of metastatic lymph nodes to the number of resected lymph nodes, has been found to be an effective tool Abbreviations: AJCC, American Joint Committee on Cancer; AUC, corresponding area under curve; C-index, concordance index; DCA, decision curve analysis; ELN, examined lymph node; OS, overall survival; PORT, postoperative radiotherapy; LNN, lymph node number; LNR, lymph node ratio; MSDC, major salivary duct carcinoma; ROC, receiver operating characteristic; SDC, salivary duct carcinoma; SGCs, salivary gland cancers; SEER, surveillance, epidemiology, and end results.…”

“…MSDC often presents in stage III‐IV with lymph node metastasis, and its prognosis is notoriously poor 9–11 . Lymph node ratio (LNR), defined as the ratio of the number of metastatic lymph nodes to the number of resected lymph nodes, has been found to be an effective tool evaluating the prognosis of many types of tumors.…”