Management and outcome of salivary duct carcinoma in major salivary glands

Abstract

Salivary duct carcinoma (SDC) is a rare and aggressive malignancy with poor prognosis. Its histomorphology is distinctly reminiscent of the ductal carcinoma of the breast. We reviewed the treatment and outcome of SDCs at a single tertiary care centre. Twenty-five cases of SDC of major salivary gland origin, diagnosed and treated at the Department of Otolaryngology, Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland, during a 14-year period from 1997 to 2011, were reviewed retrospectively. Survival outcome was analyzed for 18 patients with a minimum follow-up of 24 months. There were 16 male (64 %) and 9 female (36 %) patients with a median age of 61 years (range 36-82 years). The majority of the cases occurred in the parotid gland (n = 21, 84 %) followed by the submandibular gland (n = 4, 16 %). The primary treatment consisted of surgical resection in all cases and 17 (68 %) patients also underwent neck dissection. Most of the patients (n = 18, 72 %) were treated with postoperative radiotherapy. Seven patients (28 %) had a disease recurrence within a median follow-up time of 15 months (range 3-27 months). In the group (n = 18) with a minimum follow-up time of 24 months, the 2- and 5-year overall and disease-specific survival rates were 66, 41 % and 75, 55 %, respectively. These results confirm the aggressive nature of SDCs in major salivary glands. Diagnostics and management of these tumours need to be centralized in experienced surgical Head and Neck Oncology Centres, and new treatment strategies should be investigated.

Salivary duct carcinoma treated with cetuximab-based targeted therapy: A case report

“…By contrast, SDC metastases occur earlier and develop more rapidly, suggesting that the efficacy of lung metastasectomy for SDC may be insufficient when compared to its efficacy for ACC. In the case presented herein, SDC developed in the submandibular gland and the patient had lymph node metastases at initial diagnosis, as described previously (2,(7)(8)(9)(10)(11)(12). Radical tumor resection with ipsilateral neck dissection were first performed, followed by lung metastasectomy via VATS for left lower lung metastasis and adjuvant chemotherapy.…”

“…Kleinsasser et al (25). This type of cancer is considered to be among the most aggressive salivary gland carcinomas due to the high frequency of local recurrence, as well as associated cervical lymph node and distant metastases (2,(7)(8)(9)(10)(11)(12). The most common treatment for SDC is surgery, particularly extended radical resection and ipsilateral neck dissection, with postoperative radiotherapy (2,6,7).…”

“…Between 2005 and 2015, SDC patients were frequently diagnosed at an advanced stage, as in 55-82% of the cases the disease had already spread to the cervical lymph nodes on first diagnosis. Furthermore, local and regional recurrence and distant metastasis following surgery and postoperative radiotherapy were observed in 11-48, 8-26 and 24-63% of the patients, respectively, with a 5-year survival rate of 42-55% (2,(7)(8)(9)(10)(11)(12).…”

“…The overall 5-year survival rate associated with SDC is low (42-55%) (2,(7)(8)(9)(10)(11)(12). Recent studies have tested molecularly targeted therapies as novel treatment strategies for SDC.…”

Salivary duct carcinoma: A clinopathological report of 11 cases

“…Due to the rarity of SDC, little data regarding its clinicopathological characteristics exists. The standard treatment for SDC is surgery in combination with radiotherapy, however, the prognosis of SDC is poor (4)(5)(6)(7). Effective therapeutic strategies rely on a sufficient understanding of SDC and its prognostic factors, therefore, the aim of the present retrospective study was to summarize the clinicopathological characteristics of SDC and to evaluate the current treatment modalities currently used at the Affiliated Hospital of Stomatology of Nanjing University (Nanjing, Jiangsu, China).…”