Carcinoma of the major and minor salivary glands.Analysis of treatment results and sites and causes of failures

Abstract

Between January 1957 and June 1974, 173 patients with carcinoma of the supraglottic larynx were treated by an integrated approach at the University of California in San Francisco. The policy was to use radiotherapy or surgery alone for Stage I and II disease, radiotherapy combined with either supraglottic laryngectomy or total laryngectomy for resectable Stage III and IV disease, and radiotherapy alone for advanced unresectable disease. Control of the disease in the primary site was achieved in 92% of T1a, 88% of T1b, 80% of T2, 79% of T3 and 56% of T4 lesions. Of the 36 patients with late Stage I and resectable Stages III and IV disease treated by combined preoperative radiotherapy and supraglottic or total laryngectomy, the primary lesion was controlled in 33 (92%). Recurrent disease in the primary site after radiotherapy alone, when detected early, was usually controlled by subsequent surgery, whereas recurrent disease after surgery was not controlled by radiotherapy. Preservation of a functioning vocal apparatus was achieved in 44% of the patients whose primary lesion was controlled. Control of cervical lymph node metastasis was achieved in 71% of N1, 38% of N2, and 25% of N3 disease. No disease recurred in the radically dissected neck which received preoperative radiotherapy. Radiotherapy also reduced the incidence of subsequent neck disease in patients without cervical lymph node metastasis initially from 23% to 14%.

Results of surgery plus postoperative radiotherapy for patients with malignant parotid tumor

“…Five-year locoregional control of 73-92 % has been reported after use of postoperative radiotherapy (Table 3) [6,9,[12][13][14][15][16][17][18][19]. Our results showed locoregional control was comparable with that in previous studies.…”

Management of Regional Metastases of Malignant Salivary Gland Neoplasms

“…While there are no prospective or randomized studies to support this use of postoperative radiation, the results of several retrospective reports have indicated that it improves local-regional control and survival [7][8][9] . Armstrong et al [10] performed matched-pair analysis of patients treated for salivary cancer with nodal metastasis, with one cohort of patients receiving surgery alone and the other cohort receiving postoperative radiation.…”

“…In many of these cases, the first echelon is represented by the intraparotid lymph nodes. The mean numbers of intraparotid lymph nodes that have been reported are 7 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] in the superficial lobe and 2 (range, 0-9) in the deep lobe [38] . Furthermore, a statistically significant correlation (p = 0.005) has been observed between the presence of intraparotid metastatic nodes and neck node metastases [39] .…”

Adenocarcinoma Not Otherwise Specified on Dorsum of Tongue: Case Report and Literature Review

“…The mainstay of treatment of oropharyngeal adenocarcinoma of minor salivary gland origin includes surgical excision with or without adjuvant radiotherapy 22 . Complex reconstruction is often required after radical excision because of the location of the lesions 4 .…”