Carcinoma Ex Pleomorphic Adenoma: Is It a High-Grade Malignancy?

Ye, Peng; Gao, Yan; Mao, Chi; Guo, Chuanbin; Yu, Guang‐Yan; Peng, Xin

doi:10.1016/j.joms.2016.03.037

Cited by 21 publications

(34 citation statements)

References 19 publications

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“…The most frequently diagnosed histopathological subtype in the analysed samples varied according to the assessed studies, with salivary duct carcinoma most frequently diagnosed in three studies, while Griffith et al included only cases diagnosed as salivary duct carcinoma in their sample. The most diagnosed histopathological subtype reported by Ye et al was myoepithelial carcinoma. Non‐specified adenocarcinoma was the most reported in three studies .…”

Section: Resultsmentioning

confidence: 91%

“…Patients were more frequently diagnosed in more advanced clinical stages (III/IV) in the studies carried out by Lewis et al, Weiler et al, Mariano et al and Zhao et al . Cases diagnosed in early clinical stages were more frequent in two studies, and clinical staging was not evaluated in two studies …”

Section: Resultsmentioning

confidence: 95%

“…In the analysis carried out by Ye et al, more than half of the patients presenting frankly invasive CXPA (>1.5 mm) developed local recurrence (54.1%), while distant metastasis occurred in 21 patients (15.6%) and 25 (18.5%) developed cervical metastasis. Sixty patients in this group (44.4%) died due to the neoplastic process.…”

Section: Resultsmentioning

confidence: 97%

“…After screening of the titles and abstracts, 18 studies were considered potentially eligible and read in full by the three evaluators. At the end of the analyses, eight published articles met all the inclusion criteria and were selected . The article screening and selection flow chart are illustrated in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…The extracapsular invasion was evaluated in all selected studies and correlated with the clinical and pathological parameters. Taking into account all studies included in the systematic review, neoplastic processes were classified as in situ, minimally invasive (depth of invasion ≤1.5 mm) and frankly invasive (>1.5 mm) . In the study carried out by Rito et al, capsular invasion was classified as in situ, ≤1.5, 2.5, 5.5, 8.0, ≥10.0 mm, while in Weiler et al, capsular invasion was classified into groups presenting invasion between 1 and 5 mm and a second group with invasion greater than or equal to 8 mm.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Extracapsular invasion: A potential prognostic marker for Carcinoma ex‐pleomorphic adenoma of the salivary glands? A Systematic Review

Morais

Pinheiro

Sena

et al. 2019

J Oral Pathology Medicine

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Background The aim of the present study was to integrate available data published in the literature on extracapsular invasion in cases of CXPA that correlated findings with the prognosis of analysed patients. Methods An electronic search was carried out at the MEDLINE/PubMed, EMBASE and Cochrane Collaboration Library databases. Articles that assessed the relationship between extracapsular invasion and survival of patients diagnosed with CXPA were selected for the systematic review. Quality assessment was performed, in duplicate, for each eligible study by independent reviewers who used the operationalized prognostic biomarker reporting the REMARK guidelines. Results Eight published articles met all the inclusion criteria and were selected. Extracapsular invasion was evaluated in all selected studies and was correlated with clinical and pathological parameters. Recurrence and death due to the neoplastic process became a frequent finding in cases of tumours with extracapsular invasion >1.5 mm, being an important cut‐off point in the prognostic analysis of cases diagnosed as CXPA. Conclusions This systematic review demonstrates the importance of evaluating extracapsular invasion in cases diagnosed as CXPA, considering that tumours with invasion >1.5 mm, regardless of histopathological subtype, are associated with a worse prognosis. It is important to analyse the extracapsular invasion, especially as an auxiliary method to assess the prognosis of cases diagnosed in the initial clinical stages, thus identifying the possible biological behaviour of the neoplastic process and guiding the most appropriate patient management.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Extracapsular invasion: A potential prognostic marker for Carcinoma ex‐pleomorphic adenoma of the salivary glands? A Systematic Review

Morais

Pinheiro

Sena

et al. 2019

J Oral Pathology Medicine

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Risk factors for carcinoma ex pleomorphic adenoma in patients presenting with recurrence after resection of pleomorphic adenoma

et al. 2020

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Background: In patients presenting with recurrent pleomorphic adenoma (rPA), clinical evaluation can fail to recognize carcinoma ex PA (cxPA). We aim to identify the risk factors for cxPA. Methods: This is a single institution retrospective case-control study from 2000 to 2015. CxPA was diagnosed based on surgical pathology. Demographics, clinical, and social histories were collected. Results: A number of 13/106 (12.3%) patients were diagnosed with cxPA, of which only 4/13 (31%) had clinical features suspicious for malignancy. Compared to benign rPA, factors associated with cxPA included age >50 (odds ratio [OR] 6.67, 95% confidence interval [CI]: 1.71-25.98, P < .01), >10 pack-years of smoking history (OR 3.36, 95% CI: 1.01-11.14, P = .04), and the largest tumor being >2 cm on pathology (OR 4.42, 95% CI: 1.14-17.10, P = .03). Conclusions: In patients presenting with rPA, risk factors for malignant transformation include age >50, significant smoking history, and tumors larger than 2 cm. Clinical signs of malignancy such as rapid growth or pain are not always present.

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Elective neck dissection in salivary gland malignancies: Systematic review and meta‐analysis

et al. 2021

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We defined the occult nodal metastasis (ONM) rate of clinical node‐negative salivary gland malignancies and examined the role of elective neck dissection (END). Meta‐analysis querying four databases, from inception of databases to March 25th, 2020. Fifty‐one studies with 11 698 patients were included. ONM rates were 64% for salivary ductal carcinoma (SDC), 51% for undifferentiated carcinoma, 34% for carcinoma ex‐pleomorphic adenoma (CXPA), 32% for adenocarcinoma not otherwise specified (ANOS), 31% for lymphoepithelial carcinoma (LE), 20% for mucoepidermoid carcinoma, 17% for acinic cell carcinoma, and 17% for adenoid cystic carcinoma. T3/T4 tumors had a 2.3 times increased risk of ONM than T1/T2 tumors. High‐grade tumors had a 3.8 times increased risk of ONM than low/intermediate‐grade tumors. ONM rates were exceedingly high for T3/T4, high‐grade, and undifferentiated, SDC, ANOS, CXPA, and LE tumors, indicating the potential role of END.

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Carcinoma Ex Pleomorphic Adenoma: Is It a High-Grade Malignancy?

Cited by 21 publications

References 19 publications

Extracapsular invasion: A potential prognostic marker for Carcinoma ex‐pleomorphic adenoma of the salivary glands? A Systematic Review

Extracapsular invasion: A potential prognostic marker for Carcinoma ex‐pleomorphic adenoma of the salivary glands? A Systematic Review

Risk factors for carcinoma ex pleomorphic adenoma in patients presenting with recurrence after resection of pleomorphic adenoma

Elective neck dissection in salivary gland malignancies: Systematic review and meta‐analysis

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