<p>The Role of Prognostic Factors in Salivary Gland Tumors Treated by Surgery and Adjuvant Radio- or Chemoradiotherapy – A Single Institution Experience</p>

Abstract

Purpose: Salivary gland neoplasms are rare cancers of the head and neck region. Radical treatment in tumors of large salivary glands is surgery. Adjuvant treatment depends on the presence of risk factors that worsen the prognosis, but the role of these factors in patients treated by surgery with radio-or radiochemotherapy still remains unclear. The aim of the study is assessment of treatment results and identification of the risk factors affecting the prognosis in patients with tumors of large salivary glands subjected to adjuvant radio-or radiochemotherapy. Patients and Methods: The study included 126 patients with local stage large salivary gland cancer who were treated surgically with adjuvant radio-or radiochemotherapy. The study excluded inoperable patients, patients with distant metastases, patients in a poor general condition and patients with contraindications to adjuvant treatment. They were treated between 2006 and 2016 and evaluated in terms of OS (overall survival), CSS (cancer-specific survival), RFS (relapse-free survival) and LRFS (local relapse-free survival). Results: During a 44-month follow-up, 5-OS, CSS, RFS and LRFS were 55%, 68%, 60% and 73%, respectively. Multivariate analysis showed that OS was influenced by the following parameters: WHO performance status, TNM stage (T and N parameters), radicality of surgery, histopathological type, applied method of radiotherapy planning and tumor volume. WHO performance status, T and N parameters of the TNM stage and large volume of elective area influenced CSS, and the T parameter of the TNM stage, the dose below 60Gy and tumor volume influenced RFS and LRFS. Chemoradiotherapy can be used in N-positive patients. Conclusion: The analysis indicates that the TNM grade, histopathological type, patient's condition, radicality of the procedure, technique and dose of radiotherapy are the most important prognostic factors in these patients.

Competing‐risks nomograms for predicting cause‐specific mortality in parotid‐gland carcinoma: A population‐based analysis

“…However, the positive effects of radiotherapy cannot be denied, since patients who received only radiotherapy still had a lower risk of GCD than those who did not receive either treatment (only radiotherapy vs surgery plus radiotherapy: sdHR = 1.619, 95% CI = 1.184–2.214; neither radiotherapy nor surgery vs surgery plus radiotherapy: sdHR = 3.580, 95% CI = 2.310–5.547). Almost all of the few studies of the effects of chemotherapy concluded that this treatment does not improve the survival of PGC patients, 12‐14,23,34 and we obtained the same result. However, Andry et al suggested that chemotherapy was effective in preventing the recurrence of PGC and can increase the disease‐free survival rate of patients 42 …”

“…And chemotherapy is mainly applied in the palliative setting 11 . The treatment strategy in individual patients is determined based on evaluations of the prognosis, 5,6,11‐14 and so inaccurate prognostic predictions may lead to either inadequate or excessive treatment 15 . The commonly used prognostic tool for PGC is the American Joint Committee on Cancer (AJCC) staging, which is based on the tumor size or the extent of invasion (T), nodal involvement (N), and distant metastasis (M).…”

Clinico-Epidemiological Analysis of Most Prevalent Parotid Gland Carcinomas in Poland over a 20-Year Period

“…The choice of appropriate treatment has a direct impact on patient prognosis, but it is not the only prognostic factor. Findings indicate clinical factors such as histopathological type and grade of lesion, advanced tumor stage, facial nerve involvement, vascular invasion, lymph node metastasis, and distant metastasis, negatively affect prognosis [ 14 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. In addition, demographic factors such as gender or age are also factors that affect prognosis [ 14 , 26 , 31 , 34 , 36 ].…”

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

“…When treating head and neck cancers, radiotherapy is often employed, either alone or in combination with surgery [ 5 , 6 , 7 , 8 ]. In order to reduce normal tissue toxicity, the use of intensity-modulated radiotherapy has been implemented [ 9 ].…”