Prognostic factors in mammary analogue secretory carcinomas of the parotid gland: Systematic review and meta‐analysis

Abstract

Mammary analogue secretory carcinomas (MASCs) of the parotid gland are considered as low‐grade malignancies with good clinical outcome but lacking data regarding prognostic factors. We performed meta‐analysis assessing prognostic factors for disease‐free survival (DFS) and overall survival (OS) in 256 patients with MASCs of the parotid gland. A total of 73 studies have met the inclusion criteria and 76.3% of patients were seen with T1 and T2 tumors and negative neck nodes. Lymph node metastasis (57.4%) and distant recurrences (46.2%) were particularly found in T4 tumors (p < 0.001). DFS at 5 and 10 years was 77.9% and 47.2% compared to 88.1% and 77.2% for OS at the same time points. Male sex, T3‐T4 tumors, and recurrent disease represented independent worse prognosticators for survival outcome. Altogether, parotid gland MASCs show good long‐term outcome, but T4 tumors behave significantly more aggressive and require extended treatment strategies along with close follow‐ups.

Salivary Gland Secretory Carcinoma; Review of 13 Years World‐Wide Experience and Meta‐Analysis

“…Our findings regarding tumor stage, regional and distant spread are consistent with reports of secretory carcinoma as a low‐grade tumor 10,115 . Over 75% of cases presented with either stage I or II disease, and about 14 and 8 percent of patients had regional and distant disease, respectively.…”

“…The recurrence rate of 19% is similar to the 19.9% described by Janik et al 115 in their meta-analysis. This figure clearly stands for the need for a close surveillance of these patients, regardless of the low-grade nature of the disease, to allow early detection and treatment of recurrent disease.…”

“…Our findings regarding tumor stage, regional and distant spread are consistent with reports of secretory carcinoma as a low-grade tumor. 10,115 Over 75% of cases presented with either stage I or II disease, and about 14 and 8 percent of patients had regional and distant disease, respectively. These figures may aid in the decisionmaking process regarding the need for systemic evaluation for metastatic disease prior to surgery, which seems redundant in cases where the disease is locally confined.…”