Céleste Rebours1, Vincent Couloigner1, Louise Galmiche2, Odile Casiraghi3, Cécile Badoual4, Sabah Boudjemaa5, Anthony Chauvin6, Monique Elmaleh7, Brice Fresneau8, Sylvie Fasola9, Erea-Noël Garabédian1, Thierry Van Den Abeele10, Daniel Orbach11. 1. Pediatric Ear, Nose, and Throat Department, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France. 2. Department of Pathology, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France. 3. Department of Pathology, Gustave Roussy Institute, Grand Campus, Villejuif, France. 4. Department of Pathology, Georges Pompidou European Hospital, Public Assistance-Hospitals of Paris, Paris, France. 5. Department of Pathology, Armand Trousseau Hospital, Public Assistance-Hospitals of Paris, Paris, France. 6. Paris Diderot University, Sorbonne Paris Cité, Public Assistance-Hospitals of Paris, Lariboisière Hospital, Emergency Services, Paris, France. 7. Department of Radiology, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France. 8. Pediatric Department, Gustave Roussy Institute, Grand Campus, Villejuif, France. 9. Hematology and Oncology Department, Armand Trousseau Hospital, Public Assistance-Hospitals of Paris, Paris, France. 10. Pediatric Ear, Nose, and Throat Department, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France. 11. Pediatric, Adolescent, and Young Adult Department, Curie Institute, Paris, France.
Abstract
OBJECTIVES/HYPOTHESIS: To analyze clinical presentations, treatment modalities, and evolution of pediatric cases of salivary gland carcinomas to standardize care for these rare diseases. STUDY DESIGN: Multicentric, retrospective study. METHODS: We included in this retrospective study all children and adolescents (aged ≤18 years) treated from 1992 to 2012 in six pediatric centers in Paris, France. Pathological tumor specimens of these cases were reviewed. RESULTS: Forty-three children were included (sex ratio male/female = 19/24, median age = 13 years). The parotid gland was the most common (37 cases) location for tumors. Histological subtypes were mucoepidermoid carcinomas (n = 20), acinic cell carcinomas (n = 14), and other (n = 9). Initial fine-needle aspiration was performed in 15 cases (33%), and was concordant to final diagnosis in three cases (20%). Primary surgery was performed in 42 patients, leading to a complete microscopic resection in 80%. Associated lymph node dissection was performed in 28 patients (homolateral: 27, bilateral: 1) and showed lymph node metastases in only two patients. One patient had distant metastases. Adjuvant irradiation was delivered to 11 patients (median: 60 Gy; range: 50-65) and chemotherapy in five cases. After a median follow-up of 5 years, six tumors relapsed, but no deaths occurred. CONCLUSIONS: Childhood salivary gland carcinomas have a good prognosis despite possible recurrences. Treatment is mainly based on surgery, with simultaneous node dissection in cases of clinical or radiologic node enlargement. Radiation therapy seems to be restricted to inoperable high-grade tumors or after recurrence. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:140-147, 2017.
OBJECTIVES/HYPOTHESIS: To analyze clinical presentations, treatment modalities, and evolution of pediatric cases of salivary gland carcinomas to standardize care for these rare diseases. STUDY DESIGN: Multicentric, retrospective study. METHODS: We included in this retrospective study all children and adolescents (aged ≤18 years) treated from 1992 to 2012 in six pediatric centers in Paris, France. Pathological tumor specimens of these cases were reviewed. RESULTS: Forty-three children were included (sex ratio male/female = 19/24, median age = 13 years). The parotid gland was the most common (37 cases) location for tumors. Histological subtypes were mucoepidermoid carcinomas (n = 20), acinic cell carcinomas (n = 14), and other (n = 9). Initial fine-needle aspiration was performed in 15 cases (33%), and was concordant to final diagnosis in three cases (20%). Primary surgery was performed in 42 patients, leading to a complete microscopic resection in 80%. Associated lymph node dissection was performed in 28 patients (homolateral: 27, bilateral: 1) and showed lymph node metastases in only two patients. One patient had distant metastases. Adjuvant irradiation was delivered to 11 patients (median: 60 Gy; range: 50-65) and chemotherapy in five cases. After a median follow-up of 5 years, six tumors relapsed, but no deaths occurred. CONCLUSIONS: Childhood salivary gland carcinomas have a good prognosis despite possible recurrences. Treatment is mainly based on surgery, with simultaneous node dissection in cases of clinical or radiologic node enlargement. Radiation therapy seems to be restricted to inoperable high-grade tumors or after recurrence. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:140-147, 2017.