Impact of anatomic site of distant metastasis on survival in salivary gland cancers

Abstract

Background As exemplified in patients with adenoid cystic carcinoma (ACC), metastatic salivary gland cancers display heterogenous behavior. Although anatomic site of metastasis has been suggested to be prognostic for survival in this population, this is not adequately characterized in the current literature. Methods Using the National Cancer Database (NCDB), patients with newly diagnosed metastatic salivary gland cancers with distant metastasis to a single organ were identified. Results Eight hundred and fifty‐eight patients (n = 284 bone‐only, n = 322 lung‐only, n = 252 other‐site‐only) were identified. Anatomic site of distant metastasis was not associated with survival in the cohort as a whole; however, on pre‐planned subgroup analysis, lung‐only metastasis, relative to bone‐only metastasis, was the only factor associated with improved survival in patients with ACC (HR: 0.52, 95%CI: 0.30–0.93, p = 0.029). Conclusions Anatomic site of metastasis is strongly associated with survival in patients with metastatic ACC and should be considered in future studies aiming to optimize therapy in this population.

Surgical Resection Improves Overall Survival in cT4b Major Salivary Gland Cancer

“…Evidence supporting the inclusion of adjuvant chemotherapy in the management of cT4b MSGC is even less clear because of exceedingly high mortality and distinct tumor biology portending poor chemosensitivity. 24,57,58 aCRT was not associated with higher OS than aRT alone in univariable analysis, strengthening existing literature that questions the utility of adjuvant chemotherapy in the management of MSGC. Treatment at an academic facility was associated with higher OS in patients undergoing definitive treatment.…”

“…pENE and PSM are validated indications for aCRT in mucosal HNSCC but unclear indications for adjuvant chemotherapy in MSGC may account for nearly half of patients with pENE or PSM undergoing aRT alone. Evidence supporting the inclusion of adjuvant chemotherapy in the management of cT4b MSGC is even less clear because of exceedingly high mortality and distinct tumor biology portending poor chemosensitivity 24,57,58 . aCRT was not associated with higher OS than aRT alone in univariable analysis, strengthening existing literature that questions the utility of adjuvant chemotherapy in the management of MSGC 5,13‐19 …”

“…Nine hundred and seventy-six patients with cT4b MSGC satisfied the inclusion criteria (Table 1). Median age (interquartile range [IQR]) was 66 (56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75) years. Most patients were male (62.6%), white (81.1%), treated at academic facilities (54.2%), had high-grade tumors (69.3%), and presented with nodal (52.6%) or distant metastases (22.7%).…”

Major and minor salivary gland cancers: A multicenter retrospective study

“…In accordance with the literature, the most common metastatic site was lung (50% of all metastatic patients) in our study. Furthermore, lung metastasis was the most common site of metastasis for all histologies 17,19,20 …”

“…Furthermore, lung metastasis was the most common site of metastasis for all histologies. 17,19,20 In the management of all salivary gland malignancies, surgical excision with negative margins is indispensable. The type, grade, and stage of malignancy are determining factors in the extent of surgery and the necessity of neck dissection.…”