Outcomes of carcinoma ex pleomorphic adenoma compared to de novo adenocarcinoma of major salivary glands

Abstract

Background and ObjectivesCarcinoma ex pleomorphic adenoma (CXPA) is a rare disease of the major salivary glands that remains poorly characterized. Our objective was to compare the clinical outcomes of patients with CXPA of the major salivary glands to those with de novo adenocarcinomas.MethodsReview of the NCDB between 2004 and 2016 to compare cases of CXPA and adenocarcinoma of major salivary glands. Demographics, clinical characteristics, and survival were analyzed.ResultsWe identified 1181 patients with CXPA and 3326 patients with adenocarcinoma of major salivary glands. Adenocarcinomas presented with higher rates of nodal metastasis (54.7% vs. 30.4%, p < .001). Five‐year survival of adenocarcinoma (55.8%) was worse than that of CXPA (68.5%, p < .001). When stratified by nodal status, there was no significant difference in 5‐year survival between CXPA and adenocarcinoma node‐negative (75.3% vs. 71.6%, respectively) and node‐positive (40.4% vs. 36.1%, respectively) patients.ConclusionsCXPAs of the major salivary glands present at an earlier stage with lower rates of regional metastasis compared to adenocarcinomas. After controlling for lymph node metastases, the outcomes are quite similar.

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

“…The OS of CPA indicates a relatively good prognosis. The presented results are better than in other studies (range 25–68.5%) [ 33 , 51 , 53 , 54 , 71 , 72 ], but worse than in the study of Zbären et al [ 79 ] who noted 5-year OS of 76%.…”

“…Poor prognosis concerns patients with adenocarcinoma, which was confirmed by other studies; 5-year OS was estimated at 43–62.2% [ 43 , 58 , 59 , 60 , 72 ]; and 10-year OS was only 20.7% [ 58 ].…”

“…CPA is a rare and aggressive parotid carcinoma, and can develop de novo or based on pleomorphic adenoma. It is poorly understood and the clinical picture of the lesion cannot be briefly characterised; the exact factors for less or more aggressive course of CPA are not known [ 51 , 71 , 72 ]. Due to the high clinical variability at the time of diagnosis, the discrepancy in prognosis is so high.…”

Clinical parameters predictors of malignant transformation of recurrent parotid pleomorphic adenoma

“…Although false positivity is common (rate of 68.9%), it should not be ignored, and our findings showed that lymph node enlargement was significantly related to MT, which was also confirmed by Seok et al 7 . The value of CT in detecting lymph node metastasis in head and neck squamous cell carcinoma has been widely evaluated 20 . The classic feature is cystic changes within the lymph node; however, there might be different manifestations from lymph node metastasis in salivary malignancy.…”

Mucoepidermoid Carcinoma Ex Pleomorphic Adenoma of Lacrimal Gland: Case Report and Review of Literature

“…4 Aging, tumor volume, radiation experience, and tumor recurrence are all possible causes of malignant transformation. 5 Adenocarcinoma, adenoid cystic carcinoma, apocrine carcinoma, myoepithelial carcinoma, and mucoepidermoid carcinoma are among the different histopathological subgroups of Ca ex PA. Ca ex PA with the histologic subtype mucoepidermoid carcinoma is extremely uncommon. 6 The majority of patients could be managed with eye-sparing surgery and radiation therapy.…”