Distant Metastases in Patients with Carcinoma of the Major Salivary Glands (original) (raw)
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International Journal of Oral and Maxillofacial Surgery, 2011
The risk of distant metastasis of salivary gland cancers has usually been associated with histological type, tumour size, and site. The aim of this study was to evaluate a series of patients with major salivary gland carcinomas in order to identify potential risk factors associated with distant metastasis. 255 patients treated for major salivary gland carcinoma in Brazil from 1953 to 2004 were reviewed. Clinical and treatment data were obtained from the medical records and histological features reviewed. 57 (22%) of 255 patients had distant metastasis. The lungs were the most common metastatic site (40 cases, 65%) and adenoid cystic carcinoma the most frequent histological type involved (27 cases, 47%). The percentage of tumours in the submandibular, parotid, and sublingual glands that presented distant metastasis was 42%, 20%, and 17%, respectively. These results provide evidences that clinicopathological factors (tumour site and histology) are significant predictors of distant metastasis in patients with major salivary gland carcinomas.
Oral and Maxillofacial Surgery Cases, 2019
The purpose of the current study was to evaluate the frequency rates of tumour recurrences and rates of metastases in patients with surgical removal of malignant salivary gland tumours throughout 5 years of follow-up after initial therapy, and determine which salivary gland and histological diagnosis are the major contributors for the occurrence. Methods: Between 2005 and 2017, 74 patients underwent surgical removal of localized malignant cancers of the salivary glands. Data were analysed retrospectively from our tertiary hospital database. The demographic characteristics (age and gender) were obtained from the patients' records. Pearson's χ-square test and logistic regression were used to analyse the data with p < 0.05 as statistically significant. Results: Malignant salivary gland tumours were mostly diagnosed at parotid gland in 51.4% of cases, thus majority of patients underwent surgical extirpation (37.8% of cases) of tumour removal. Adenocarcinoma was the most common form of malignancy (19 patients, 25.6%), followed by adenoid cystic carcinoma (13 patients 17.6%) and mucoepidermoid carcinoma (11 patients, 14.9%). Postoperative complications; namely tumour recurrences were detected in 8 patients (10.8%) throughout 5 years of follow-up after initial therapy. Metastases were observed in 6 patients (8.1%), and facial nerve paralyses were diagnosed in 19 (25.7%) of all patients and with no specific risk factors, that could have contributed to the occurrence of nerve damage. Conclusions: A significant proportion of patients who are presumed to be cured of their disease through 5 years after initial treatment for salivary gland cancer will be found to develop late disease recurrences or metastases.
Predictors of nodal metastasis in salivary gland cancer
Journal of Surgical Oncology, 2002
Objectives: This study was conducted to determine clinical and histologic factors that would predict nodal metastasis in patients with major salivary gland cancer. Methods: A retrospective study of 40 patients who underwent surgery, including neck dissection, for major salivary gland cancer between 1975 and 1997 was performed. Patient charts were reviewed, and clinical and pathologic data were extracted along with outcome. Predictive factors were identified and survival curves were obtained. Results: Neck dissections were performed in 40 patients, which revealed histologic evidence of tumor in lymph nodes in 15 cases. Histologically proven metastasis was found in 16% of specimens from elective and 73% of specimens from therapeutic neck dissection. Five-year overall and locoregional disease-free survival rates for histologically positive and negative groups were 40% versus 63% (P < 0.05) and 67% versus 69% (P ¼ 0.59), respectively. Univariate analysis of the factors revealed that clinical evidence of nodal metastasis (P < 0.001) and high-grade cancer (P < 0.033) predicted histologic nodal involvement. Multivariate analysis revealed that only a positive neck examination was a significant predictive factor (OR ¼ 31, 95%CI ¼ 2.99-312). Conclusions: Our results suggest that clinical neck examination is a reliable predictor of regional metastasis in patients with major salivary gland cancer. In view of the low frequency of occult metastases, routine elective treatment of the neck is not recommended.
Journal of Radiation Oncology, 2013
Objectives Excellent local-regional control can be achieved for major salivary gland tumors treated with surgery and postoperative radiotherapy. We evaluated the cumulative incidence and predictors of distant metastasis in high-risk major salivary gland tumors. Methods Between 1990 and 2011, 200 patients with major salivary gland tumors received postoperative radiotherapy at our center. The patients' median age was 60 years. Patients had primary tumors of the parotid gland (84 %), submandibular (16 %), and one sublingual gland. Among the patients, 34 % hadT3-T4tumors,32%hadnodalinvolvement.Otherhigh-risk featuresincludedclose/positivemarginsandhigh-gradetumors. The median RT dose was 63 Gy. Results With a median follow-up of 50 months, the 5-year local control and regional control were 88and 94%, respectively. The 5-year freedom from distant metastasis was 73 %. The median overallsurvivalwas14.6yearscorrespondingtoa5-and10-year overall survival of 77 and 59 %, respectively. T category and nodal involvement were independent predictors of distant metastasis. Nodal involvement was also an independent predictor of overall survival. Conclusions Distant relapse was the predominant mode of failure despite excellent local-regional control in high-risk major salivary gland tumors. Both advanced T category and nodal involvement were independent predictors of distant metastasis. More effective systemic therapy is needed to combat distant relapse.
Clinicopathological analysis of salivary gland carcinomas and literature review
Molecular and Clinical Oncology, 2015
Malignant salivary gland tumors are rare and exhibit a broad spectrum of phenotypic heterogeneity. The objective of this study was to investigate prognostic factors in patients with salivary gland carcinomas and review the results in light of other reports. We retrospectively reviewed 40 patients with primary salivary gland carcinomas who were diagnosed and treated at our institution between 1991 and 2014. Of the 40 tumors, 19 (47.5%) were mucoepidermoid carcinomas, 11 (27.5%) were adenoid cystic carcinomas, 7 (17.5%) were acinic cell carcinomas, 2 (5.0%) were myoepithelial carcinomas and 1 (2.5%) was a squamous cell carcinoma. Clinically positive lymph nodes were present in 4 patients (10.0%). As regards clinical stage, 15 cases (37.5%) were stage I, 13 (32.5%) were stage II, 1 (2.5%) was stage III and 11 (27.5%) were stage IVA. The majority of the patients (97.5%) were treated with surgery, of whom 25 (62.5%) received surgery alone and 14 (35.0%) underwent surgery in combination with chemotherapy or chemotherapy and radiotherapy. The median follow-up time for all the patients was 48 months. The disease-specific survival rate at 5 years was 87.1%. We identified a significant correlation between poor survival rate and histological grade (intermediate/high), tumor size (T3/T4), lymph node metastasis (node-positive) and clinical stage (III/IV) using the Kaplan-Meier method (P<0.05 for each). In addition, the Cox proportional hazards regression analysis confirmed that lymph node metastasis and tumor size were independent prognostic factors for disease-specific survival (hazard ratio = 18.7 and 15.1, respectively; P=0.023 and 0.037, respectively). Furthermore, tumor size was found to be a predictive factor regarding recurrence in the multivariate logistic regression analysis (odds ratio = 8.35; P=0.025). Our results suggest that lymph node metastasis and tumor size are significant prognostic factors for patients with salivary gland carcinomas.
A predictive nomogram for recurrence of carcinoma of the major salivary glands
JAMA otolaryngology-- head & neck surgery, 2013
This nomogram quantifies the risk of recurrence in patients with carcinoma of the major salivary glands. It may facilitate patient counseling on prognosis and may help guide management and posttreatment surveillance in these patients. To identify factors predictive of recurrence after primary surgical treatment of carcinoma of the major salivary glands and create a nomogram that could be used to predict the risk of recurrence in an individual patient. DESIGN Retrospective case series. SETTING Single institution tertiary care cancer center. After institutional review board approval, 301 patients with previously untreated malignant salivary gland tumors treated at our institution between the years 1985 and 2009 were identified. Among the 301 patients, the median age was 62 (range, 9-89) years and 156 (52%) were male. Patient, tumor, and treatment characteristics were recorded from a retrospective analysis of patient medical charts. Overall mortality was calculated using the Kaplan-Mei...
Predictors of Outcomes in Large Cell Undifferentiated Carcinoma of the Major Salivary Glands
Objective: Major salivary gland large-cell undifferentiated carcinoma (LCUC) is rare and has a poor prognosis. Characterization of patient demographics, tumor characteristics, and predictors of outcome have been limited by low case numbers, as well as grouped analysis with other salivary malignancies. The objective of this study was to address these issues using large-scale national data.
Outcomes and prognostic factors in modern era management of major salivary gland cancer
Oral oncology, 2015
There is a dearth of prospective evidence regarding cancer of the major salivary glands. Outcomes and management of major salivary gland are based largely on retrospective series spanning many decades and changes in surgical, radiation, imaging and systemic therapy strategies and technique. We sought to report contemporary patterns of relapse and prognostic factors for major salivary gland cancer. 112 patients with major salivary gland cancers underwent resection with or without adjuvant therapy between January 1997 and September 2010. Outcomes were documented with follow-up until December 2014. Survival was calculated by the Kaplan-Meier method. Log-rank test and Cox proportional hazards regression were performed with locoregional control (LRC), distant control (DC) and overall survival (OS) as the primary outcome variables. Median follow-up was 55.1months. Rates of LRC for stage I/II and III/IV at five years were 95.7% and 61.9% respectively. Rates of DC at five years for stage I/...