Ten Year Experience with Surgery and Radiation in the Management of Malignant Major Salivary Gland Tumors

Abstract

Background: Despite being rare in incidence, malignant tumors of major salivary glands show diverse histological variation. There are limited data on major salivary gland tumor management and outcome from Pakistan. The objective of this study was to share our experience with management of malignant tumors of major salivary glands. Materials and Methods: Patients who received treatment at Shaukat Khanum Cancer Hospital and Research Center from July 2002 to June 2011 with an underlying diagnosis of a major salivary gland malignancy were included. Patient characteristics and treatment modalities were assessed. Local, regional and distant failures were determined. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan Meier curves and the Log rank test was used to determine statistical significance. Univariate and multivariate analyses were performed using Cox proportional hazard regression. Results: The parotid gland was the primary site of origin in 104 (80%) patients. Mucoepidermoid carcinoma (43%) and adenoid cystic carcinoma (24%) were the most common histological types. Surgery followed by adjuvant radiation remained the mainstay treatment modality with 81 (62%) patients. Nineteen (15%) patients were treated with surgery alone and 30 (23%) patients with locally advanced surgically inoperable tumors received radiation only. Forty one (32%) patients failed the treatment (local 12, regional 11, locoregional 5, distant 13). The expected 5 year DFS and OS were 65% and 74% respectively. On multivariate analysis, grade was the only independent predictor of DFS and nodal involvement was the only independent predictor of overall survival. Conclusions: Employing existing standards of treatment, comparable survival can be achieved in Pakistani population with major salivary gland malignancies as elsehwere in the world.

Outcome of Surgery and Post-Operative Radiotherapy for Major Salivary Gland Carcinoma: Ten Year Experience from a Single Institute

“…(Teo et al, 2000). A recent study by Iqbal et al showed that grade was the only independent predictor of disease free survival and nodal involvement was the only independent predictor of overall survival (Iqbal et al, 2014). Patients with adenoid cystic carcinoma of the major salivary glands treated with surgery and radiation have excellent overall control rates with 5 and 10 year local control rates of 94% and 73% (Theresa et al, 2005).…”

Histopathological Diversity in Parotidectomy Materials in Turkish Population: Clinicopathologic Analysis and Demographic Features of 136 Cases in a Tertiary Care Hospital

“…In addition to studies demonstrating MEC as the most prevalent tumor in literature there were also investigators who found different results. The rates reporting MEC as the 1st most prevalent tumor among series were 60% (Vargas et al, 2002), 31.7% (Lima et al, 2005), 60% (Ali et al, 2010), and 20% (Kizil et al, 2013), and 43% (Iqbal et al, 2014). Some authors (Gunizi and Guney, 2013) reported the MEC frequency at an equal rate with SqCC (21.8%), while other authors reported it as the 2nd most prevalent tumor with 25% after SqCCa.…”

Bronchial Mucoepidermoid Carcinoma Successfully Treated with Radiation Therapy: A Case Report

“…And almost 20% of that patients have been cured with RT alone [29]. Therefore, RT is now widely conducted in inoperable and postoperative salivary MEC and the results were reported as effective palliation and disease control [30,31].…”