Survival rates and prognostic factors for infiltrating salivary duct carcinoma: Analysis of 228 cases from the Surveillance, Epidemiology, and End Results database

Jayaprakash, Vijayvel; Merzianu, Mihai; Warren, Graham; Arshad, Hassan; Hicks, Wesley L.; Rigual, Néstor R.; Sullivan, Maureen; Seshadri, Mukund; Marshall, James R.; Cohan, David; Zhao, Yujie; Singh, Anurag K.

doi:10.1002/hed.23350

Cited by 132 publications

(206 citation statements)

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“…SDC is most frequently seen in men aged 50 or older [4, 6, 16, 18, 19] and is one of the more rare malignant salivary tumors. In one series of all salivary gland cancers during a 5-year period in Finland, it was estimated that 4–6% were SDC [20].…”

Section: Introductionmentioning

confidence: 99%

“…In one series of all salivary gland cancers during a 5-year period in Finland, it was estimated that 4–6% were SDC [20]. A review of the SEER Medicare Database found that SDC comprised 1.8% of all major salivary gland cancers included in the database [19]. …”

Section: Introductionmentioning

confidence: 99%

“…The risk of pathologic N+ disease ranges from 47–83% in the literature [2, 4–10, 12, 14–16, 18, 19, 22, 31–40]. However, analyses using national databases or multiple institutions described an N+ incidence of 47–56% [2, 19, 35–38].…”

Section: Introductionmentioning

confidence: 99%

“…However, analyses using national databases or multiple institutions described an N+ incidence of 47–56% [2, 19, 35–38]. In a National Cancer Data Base (NCDB) analysis of 22,653 patients with parotid malignancies, the risk of N+ disease and occult nodal disease were 54% and 24%, respectively, for patients with SDC, higher than that seen for any other parotid gland pathologies (mean for all parotid malignancies: 24% and 10%, respectively) [36].…”

Section: Introductionmentioning

confidence: 99%

“…In a National Cancer Data Base (NCDB) analysis of 22,653 patients with parotid malignancies, the risk of N+ disease and occult nodal disease were 54% and 24%, respectively, for patients with SDC, higher than that seen for any other parotid gland pathologies (mean for all parotid malignancies: 24% and 10%, respectively) [36]. Among patients with SDC, tumor size (>3cm) and histologic grade have been identified as risk factors for nodal involvement [19, 36]. …”

Section: Introductionmentioning

confidence: 99%

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Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

2017

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Salivary duct carcinoma (SDC) is a rare, aggressive salivary malignancy that is often diagnosed at an advanced stage. Previously, little was known about outcomes of this disease due to its rarity. In the past several years, much has been learned about salivary duct carcinoma after publication of outcomes from several large single-institution series and national database searches. Recent studies of genomic alterations have helped elucidate the biology and pathogenesis of this aggressive disease. Here we review outcomes of the disease, effects of treatment, prognostic factors, and genomic alterations in SDC. Studies of targeted therapy and promising future directions are also discussed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

2017

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A 20-Year Review of 75 Cases of Salivary Duct Carcinoma

Gilbert

Sharma

Schmitt

et al. 2016

JAMA Otolaryngol Head Neck Surg

127

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IMPORTANCE Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. OBJECTIVE To review the University of Pittsburgh Medical Center’s experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. DESIGN, SETTING, AND PARTICIPANTS This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution’s Head and Neck Oncology Database for further clinical details. MAIN OUTCOMES AND MEASURES Primary outcome measures consisted of OS and DFS. RESULTS The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33–93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4.5 years, respectively). Although underpowered, multivariable analysis demonstrated significantly worse OS in patients with N2 and N3 disease (hazard ratio [HR] 8.42, 95% CI, 1.84–38.5) but did not show significantly worse DFS or OS for facial nerve sacrifice or extracapsular spread. There was no association between ERBB2 positivity and survival and no difference in survival between patients receiving radiation therapy vs radiation therapy plus chemotherapy. No patients had recurrence or distant metastasis after 5 disease-free years. CONCLUSIONS AND RELEVANCE Salivary duct carcinoma is an aggressive disease. A large number of cases in this review were carcinoma ex pleomorphic adenoma and had classic negative prognostic indicators, such as perineural invasion, vascular invasion, and extracapsular spread. ERBB2 positivity was not associated with any difference in survival. Facial nerve involvement appears to indicate worse prognosis, as does nodal stage higher th...

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Treatment patterns and outcomes of palliative systemic therapy in patients with salivary duct carcinoma and adenocarcinoma, not otherwise specified

Sousa

Wang

Torman

et al. 2021

Cancer

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BACKGROUND: Salivary duct carcinoma (SDC) and adenocarcinoma, not otherwise specified (adeno-NOS), are rare salivary gland cancers. Data on the efficacy of systemic therapy for these diseases are limited. METHODS: Data were retrospectively collected from patients seen at The University of Texas MD Anderson Cancer Center during 1990 to 2020. Objective response rate (ORR) was assessed per RECIST v1.1. Recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS) were assessed by Kaplan-Meier method. Cox regression model was performed to identify predictors of survival. RESULTS: The analysis included 200 patients (110 with SDC and 90 with adeno-NOS); 77% had androgen-receptor-positive tumors and 47% had HER2-positive (2+-3+) tumors. Most patients without metastasis at diagnosis underwent surgery (98%) and postoperative radiotherapy (87%). Recurrence rate was 55%, and the median RFS was 2 years. Nodal involvement and positive surgical margins were associated with recurrence (P < .005). Among patients with stage IVA-B disease, addition of systemic therapy to local therapy increased OS (P = .049). The most-used palliative-systemic-therapy regimen was platinum doublet ± trastuzumab. For first-line therapy, the ORR and median PFS were 33% and 5.76 months, respectively, and for second-line therapy the ORR and median PFS were 25% and 5.3 months, respectively. ORR and PFS were higher with HER2targeting agents. Median OS was 5 years overall and 2 years for metastatic disease. Older age and higher stage were associated with worse OS. CONCLUSION: Adding systemic therapy to local therapy may improve outcomes of patients with locoregionally advanced SDC or adeno-NOS. Except for HER2-targeted therapy, response to palliative systemic therapy is limited. These findings may be used as a benchmark for future drug development.

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Survival rates and prognostic factors for infiltrating salivary duct carcinoma: Analysis of 228 cases from the Surveillance, Epidemiology, and End Results database

Cited by 132 publications

References 24 publications

Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

A 20-Year Review of 75 Cases of Salivary Duct Carcinoma

Treatment patterns and outcomes of palliative systemic therapy in patients with salivary duct carcinoma and adenocarcinoma, not otherwise specified

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