Survival Outcome of Intermediate-Grade Salivary Gland Carcinoma

Abstract

Objective: Histological grade is the most important factor for defining treatment strategies and predicting prognosis for salivary gland carcinoma (SGC). We examined factors affecting long-term recurrence and survival among intermediate-grade SGC (IGSGC) patients to define optimal treatment modalities and outcomes. Methods: We reviewed the clinical and pathological data on 108 IGSGC patients who underwent definitive surgery with or without postoperative radiotherapy. We compared treatment outcomes by treatment strategies such as surgical extent for the primary tumor, neck dissection, or postoperative radiotherapy. Results: During a 103-month median follow-up, local, regional, and distant recurrences were detected in 14 (13.0%), 3 (2.8%), and 21 (19.4%) patients, respectively. The 10-year locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) rates were 83.1, 76.0, and 80.1%, respectively. Multivariate analyses identified a nonparotid primary site as an independent prognostic factor for LRC (p = 0.018). Adenoid cystic carcinoma and a positive pN classification were significantly unfavorable prognostic factors for DMFS (p = 0.025 and p = 0.030, respectively); overall advanced stage was an independent prognostic factor for OS (p = 0.020). Surgical extent, elective neck dissection, and postoperative adjuvant radiotherapy did not significantly affect treatment outcomes. Conclusion: Patients with early-stage IGSGC of parotid origin can achieve favorable treatment outcomes with conservative surgery alone.

Examined and positive lymph nodes counts and lymph nodes ratio are associated with survival in major salivary gland cancer

“…Previously, the histological grade has been identified as the most predictive factor in the prognosis for SGC . In our study, patients with major salivary gland squamous cell carcinoma are found to have a lower survival.…”

Estimating survival after salvage surgery for recurrent salivary gland cancers: Systematic review

“…The remaining 1496 abstracts were screened for eligibility, yielding 131 manuscripts. Their full text evaluation identified 64 studies meeting the inclusion criteria 17–80 …”

“…On the other hand, only 5 articles (7.8%) 35,49,50,57,70 reported a study period shorter than 10 years. The remaining 46 papers (71.9%) presented a median study period of 16 years 17–20,22–26,28–31,33,36–42,44–48,51–55,59–64,66,68,69,71–74,78,79 …”

Elective neck dissection in salivary gland malignancies: Systematic review and meta‐analysis

“…Fifty‐one studies comprising a total of 11 698 patients (5636 [48%] males) were included 3,15–66 . The mean age was 57.1 years, range 2–97 years.…”

“…Additionally, 13 studies reported ONM data stratified by pathologic grade (Table 2). 18,27,35,38,42,45,48,49,59,63–66 High‐grade tumors had a 3.76 increased risk of ONM than low‐intermediate grade tumors (RR 3.76, 95% CI = 2.89–4.89) (Figure 3). Low‐intermediate grade tumors had a pooled ONM rate of 8.7% (95% CI = 5.3%–12.7%); high‐grade tumors had a pooled ONM rate of 31.9% (95% CI = 19.4%–45.8%).…”