OBJECTIVES: Excellent local-regional control can be achieved for major salivary gland tumors treated with surgery and post-operative 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 post-operative 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% had T3-T4 tumors, 32% had nodal involvement. Other high-risk features included close/positive margins and high grade tumors. 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 88% and 94%, respectively. The 5-year freedom from distant metastasis was 73%. The median overall survival was 14.6 years corresponding to a 5 and 10-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.
OBJECTIVES: Excellent local-regional control can be achieved for major salivary gland tumors treated with surgery and post-operative 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 post-operative 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% had T3-T4 tumors, 32% had nodal involvement. Other high-risk features included close/positive margins and high grade tumors. 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 88% and 94%, respectively. The 5-year freedom from distant metastasis was 73%. The median overall survival was 14.6 years corresponding to a 5 and 10-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.
Authors: Jonathan D Schoenfeld; David J Sher; Charles M Norris; Robert I Haddad; Marshall R Posner; Tracy A Balboni; Roy B Tishler Journal: Int J Radiat Oncol Biol Phys Date: 2010-11-13 Impact factor: 7.038
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Authors: William M Mendenhall; Christopher G Morris; Robert J Amdur; John W Werning; Douglas B Villaret Journal: Cancer Date: 2005-06-15 Impact factor: 6.860
Authors: Aaron W Pederson; Joseph K Salama; Daniel J Haraf; Mary Ellen Witt; Kerstin M Stenson; Louis Portugal; Tanguy Seiwert; Victoria M Villaflor; Ezra E W Cohen; Everett E Vokes; Elizabeth A Blair Journal: Head Neck Oncol Date: 2011-07-26
Authors: Kaveh Zakeri; Huili Wang; Jung Julie Kang; Anna Lee; Paul Romesser; Nader Mohamed; Daphna Gelblum; Eric Sherman; Lara Dunn; Jay Boyle; Richard Wong; Linda Chen; Yao Yu; C Jillian Tsai; Sean M McBride; Nadeem Riaz; Nancy Lee Journal: Head Neck Date: 2021-02-19 Impact factor: 3.821