Patterns of treatment failure in salivary gland cancers

Szewczyk, Mateusz; Golusiński, Paweł; Pazdrowski, Jakub; Pieńkowski, Piotr; Marszałek, Sławomir; Sygut, Jacek

doi:10.1016/j.rpor.2018.05.004

Cited by 13 publications

(13 citation statements)

References 20 publications

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“…Parotid gland cancer is an uncommon neoplasm [1], but according to their architectural and cytological features, there were 24 types of malignant tumors classified by The World Health Organization [2, 3], mucoepidermoid carcinoma (MEC) is the most common pathologic subtype, some clinic-pathologic variables, including histologic grade, lymphovascular and perineural invasion as well as tumor stage, have been well described to be associated with the prognosis in parotid MEC [4–6]. …”

Section: Introductionmentioning

confidence: 99%

Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland

2019

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s Background Prognostic factors for parotid mucoepidermoid carcinoma (MEC) usually include disease grade, tumor stage, node stage, perineural invasion, and lymphovascular invasion. But the role of intraparotid nodes (IPNs) remains unclear, therefore, the study aimed to analyze the significance of IPNs in predicting recurrence in parotid MEC. Methods One hundred and ninety patients were included for analysis finally. Data regarding demography, pathological characteristics, IPN metastasis, TNM stage, follow up was collected and evaluated. The recurrence-free survival (RFS) was the main study endpoint. Results A total of 47 (24.7%) patients had IPN metastasis, and the IPN metastasis was significantly related to tumor stage, pathologic N stage, lymph-vascular invasion, perineural invasion, and disease grade. Recurrence occurred in 34 (17.9%) patients. For patients without IPN metastasis, the 10-year RFS rate was 88%, for patients with IPN metastasis, the 10-year RFS rate was 54%, the difference was significant ( p < 0.001). Further Cox model analysis confirmed the independence of IPN metastasis in predicting the prognosis. Conclusion The IPN metastasis is relatively common in parotid MEC, it is significantly related to tumor stage and disease grade, IPN metastasis means worse recurrence-free survival.

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Section: Introductionmentioning

confidence: 99%

Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland

2019

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“…Local recurrence is one of the most common treatment failure patterns. A number of clinical and pathologic variables have been well noted to be related to local recurrence in PGC, including higher tumor (T) stage, high histologic grade, perineural invasion, and lymphovascular invasion …”

Section: Introductionmentioning

confidence: 99%

Significance of intraparotid node metastasis in predicting local control in primary parotid cancer

et al. 2018

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Objective To analyze the metastasis rate in intraglandular lymph nodes (IGLNs) with a focus on discussing the significance of IGLN metastasis in local control (LC) of parotid gland cancer (PGC). Methods A total of 337 patients were enrolled. Information including age; sex; and pathologic variables such as tumor (T) stage, IGLN metastasis, and follow‐up findings was extracted and analyzed. Results IGLN metastasis was noted in 111 (32.9%) patients. Tumor stage, pathologic nodal stage, perineural invasion, resection status, and lymphovascular invasion were significantly related to IGLN metastasis. Local recurrence was noted in 67 (19.9%) patients. IGLN metastasis was an independent predictor of LC. The 10‐year LC rate was 94% for patients without IGLN metastasis, 56% for patients with metastasis in no more than two IGLNs, and 22% for patients with metastasis in more than two IGLNs. This difference was significant (P < 0.001). Conclusion The IGLN metastasis rate is relatively high in PGC patients and is significantly associated with disease grade and T stage. IGLN metastasis is associated with poorer local LC, and patients with more than two metastatic nodes have the worst prognosis. Level of Evidence 4 Laryngoscope, 129:2309–2312, 2019

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“…Margin definition and documentation may vary among practicing surgeons and pathologists, introducing variability we were not able to account for. While we did not analyze the impact of positive surgical margins in our cohort, past literature, as mentioned in the introduction, has identified its role as a negative prognosticator in parotid malignancies . However, positive margins may not always indicate an inferior surgical result.…”

Section: Discussionmentioning

confidence: 95%

“…Positive surgical margins in parotid malignancies have consistently been associated with inferior outcomes, including increased risk of recurrence and diminished survival . Additionally, positive or close margins are two of the indications for adjuvant treatment, emphasizing the beneficial role of adequate surgical resection in order to eliminate the morbidity associated with radiation and chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins

et al. 2019

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Objectives Determine rate of preoperative biopsy in parotid malignancies, identify factors associated with its use, and its association with surgical margins. Study Design Retrospective cohort. Setting Commission on Cancer–Accredited Institutions. Subjects and Methods We included 5533 patients treated surgically for a parotid malignancy 2004–2014 in the National Cancer Database. Chi‐squared tests, univariable, and multivariable logistic regressions were used to evaluate predictors of preoperative biopsy (defined as needle, aspiration, or incisional), and associate biopsy with surgical margins. Results Preoperative biopsy was utilized in 26.0% of patients. Biopsy was more likely in patients >60 years (odds ratio [OR]: 1.19, P = .035), advanced clinical T stage (vs. T1,T2 OR: 1.23, P = .009; T3 OR: 1.26, P = .026; T4A OR: 2.05, P < .001), advanced clinical N stage (vs. N0, N1: OR: 1.39, P = .013; N2/3: OR: 1.63, P < .001), in academic centers (OR: 1.18, P < .024), and in higher volume centers (vs. low, medium OR: 1.28, P = .002; high OR: 2.16, P < .001). Biopsy use increased over time (vs. 2004–2006, 2007–2010 OR: 1.20, P = .047; 2011–2014 OR: 1.39, P < .001). Biopsy was associated with a reduced risk of positive margins in patients with clinical T1 stage (OR: 0.70, P = .012), and younger than 61 (OR: 0.79, P = .036). Conclusion The national rate of preoperative biopsy in parotid malignancy is low at 26.0%, but has increased over time. Preoperative biopsy is associated with a reduced risk of positive margins in younger patients and those with early clinical stage, suggesting its increased use may improve surgical outcomes and decrease reoperation or adjuvant therapy in these subgroups of patients. Level of Evidence 3 Laryngoscope, 130:1450–1458, 2020

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Patterns of treatment failure in salivary gland cancers

Cited by 13 publications

References 20 publications

Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland

Role of intraparotid node metastasis in mucoepidermoid carcinoma of the parotid gland

Significance of intraparotid node metastasis in predicting local control in primary parotid cancer

Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins

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