Naresh Jegadeesh1, Yuan Liu2, Roshan S Prabhu3, Kelly R Magliocca4, David M Marcus5, Kristin A Higgins6, Jeffrey M Vainshtein6, J Trad Wadsworth7, Jonathan J Beitler6. 1. Departments of Radiation Oncology, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States. Electronic address: njegadeesh@emory.edu. 2. Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States. 3. Southeast Radiation Oncology Group, Levine Cancer Institute, Charlotte, NC, United States. 4. Departments of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States. 5. Valley View Hospital, Glenwood Springs, CO, United States. 6. Departments of Radiation Oncology, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States. 7. Departments of Otolaryngology, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States.
Abstract
OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: Median follow-up was 55.1 months. 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/II and III/IV were 93% and 56.9% respectively. Multivariate analysis identified larger tumor size, clinical nerve involvement and in parotid cancers, advanced T stage, no adjuvant radiation, and older age at diagnosis to be associated with increased risk of locoregional recurrence (all p<0.05). Distant metastasis was associated with sublingual site, degree of clinical nerve involvement, high grade, tumor size and in parotid tumors additionally deep lobe involvement on multivariate analysis (all p<0.05). CONCLUSION: Several prognostic factors were identified that may help guide decisions regarding adjuvant therapy. DM remains a significant concern in the management of this disease.
OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: Median follow-up was 55.1 months. 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/II and III/IV were 93% and 56.9% respectively. Multivariate analysis identified larger tumor size, clinical nerve involvement and in parotid cancers, advanced T stage, no adjuvant radiation, and older age at diagnosis to be associated with increased risk of locoregional recurrence (all p<0.05). Distant metastasis was associated with sublingual site, degree of clinical nerve involvement, high grade, tumor size and in parotid tumors additionally deep lobe involvement on multivariate analysis (all p<0.05). CONCLUSION: Several prognostic factors were identified that may help guide decisions regarding adjuvant therapy. DM remains a significant concern in the management of this disease.
Authors: Arlene A Forastiere; Helmuth Goepfert; Moshe Maor; Thomas F Pajak; Randal Weber; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Clifford Chao; Glen Peters; Ding-Jen Lee; Andrea Leaf; John Ensley; Jay Cooper Journal: N Engl J Med Date: 2003-11-27 Impact factor: 91.245
Authors: Jay S Cooper; Thomas F Pajak; Arlene A Forastiere; John Jacobs; Bruce H Campbell; Scott B Saxman; Julie A Kish; Harold E Kim; Anthony J Cmelak; Marvin Rotman; Mitchell Machtay; John F Ensley; K S Clifford Chao; Christopher J Schultz; Nancy Lee; Karen K Fu Journal: N Engl J Med Date: 2004-05-06 Impact factor: 91.245
Authors: Jacques Bernier; Christian Domenge; Mahmut Ozsahin; Katarzyna Matuszewska; Jean-Louis Lefèbvre; Richard H Greiner; Jordi Giralt; Philippe Maingon; Frédéric Rolland; Michel Bolla; Francesco Cognetti; Jean Bourhis; Anne Kirkpatrick; Martine van Glabbeke Journal: N Engl J Med Date: 2004-05-06 Impact factor: 91.245
Authors: A S Garden; A K el-Naggar; W H Morrison; D L Callender; K K Ang; L J Peters Journal: Int J Radiat Oncol Biol Phys Date: 1997-01-01 Impact factor: 7.038
Authors: Chris H J Terhaard; H Lubsen; I Van der Tweel; F J M Hilgers; W M H Eijkenboom; H A M Marres; R E Tjho-Heslinga; J M A de Jong; J L N Roodenburg Journal: Head Neck Date: 2004-08 Impact factor: 3.147
Authors: Robert Haddad; A Dimitrios Colevas; Jeffrey F Krane; Dennis Cooper; Bonnie Glisson; Philip C Amrein; Linda Weeks; Rosemary Costello; Marshall Posner Journal: Oral Oncol Date: 2003-10 Impact factor: 5.337
Authors: Ximena Mimica; Marlena McGill; Ashley Hay; Daniella Karassawa Zanoni; Jatin P Shah; Richard J Wong; Alan L Ho; Marc A Cohen; Snehal G Patel; Ian Ganly Journal: Oral Oncol Date: 2019-05-22 Impact factor: 5.337
Authors: Nolan B Seim; Ramez H W Philips; Lynn Schoenfield; Theodoros N Teknos; James W Rocco; Amit Agrawal; Enver Ozer; Ricardo L Carrau; Stephen Y Kang; Matthew O Old Journal: Head Neck Pathol Date: 2017-03-27
Authors: Diane Wenhua Chen; Jan S Lewin; Li Xu; Stephen Y Lai; G Brandon Gunn; Clifton David Fuller; Abdallah S R Mohamed; Aasheesh Kanwar; Erich M Sturgis; Katherine A Hutcheson Journal: Otolaryngol Head Neck Surg Date: 2016-10-03 Impact factor: 3.497