Laurie Saloner Dahan1, Roch Giorgi2, Sébastien Vergez3, Ludovic Le Taillandier de Gabory4, Valérie Costes-Martineau5, Philippe Herman6, Gilles Poissonnet7, Olivier Mauvais8, Olivier Malard9, Renaud Garrel10, Emmanuelle Uro-Coste11, Béatrix Barry12, Christine Bach13, Dominique Chevalier14, Francois Mouawad14, Jean-Claude Merol15, Vianney Bastit16, Juliette Thariat16, Laurent Gilain17, Xavier Dufour18, Christian-Adrien Righini19, Antoine Moya-Plana20, Caroline Even20, Thomas Radulesco1, Justin Michel1, Bertrand Baujat21, Nicolas Fakhry22. 1. Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, 147 Boulevard Baille, 13005, Marseille, France; Aix Marseille Univ, Marseille, France; REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France. 2. Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de L'Information et de La Communication, Marseille, France. 3. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Toulouse / Oncopôle, Toulouse, France. 4. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Bordeaux, France. 5. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'Anatomie Pathologique, CHU de Montpellier, France. 6. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL Chirurgie Maxillo-faciale et Plastique, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France. 7. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, Centre Antoine Lacassagne, Institut Universitaire de La Face et du Cou, Nice, France. 8. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL, Audiophoniatrie, Chirurgie Cervico-faciale, CHU de Besançon, France. 9. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Nantes, France. 10. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Montpellier, Montpellier, France. 11. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'Anatomie et Cytologie Pathologiques, Institut Universitaire du Cancer-Oncopole, Toulouse, France. 12. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU Paris Nord-Val de Seine, Hôpital Xavier Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France. 13. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie de La Face et du Cou, Hôpital Foch, Suresnes, France. 14. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Lille, France. 15. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Reims, France. 16. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, Centre François Baclesse, Caen, France. 17. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Clermont-Ferrand, France. 18. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Poitiers, France. 19. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'ORL et Chirurgie Cervico-faciale, CHU de Grenoble, France. 20. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Service d'Oncologie Médicale Tête et Cou, Institut Gustave Roussy, Villejuif, France. 21. REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France; Sorbonne Université; Service d'ORL et Chirurgie Cervico-faciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France. 22. Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, 147 Boulevard Baille, 13005, Marseille, France; Aix Marseille Univ, Marseille, France; REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France. Electronic address: nicolas.fakhry@ap-hm.fr.
Abstract
BACKGROUND: To describe the characteristics of the largest European study of MEC of salivary glands and to determine the prognostic factors for overall and disease free survival. PATIENTS AND METHODS: Patients with MEC were prospectively included in the Réseau d'Expertise Français sur les Cancers ORL Rares (REFCOR, French Network of Rare Head and Neck Tumors) database between 2009 and 2015. RESULTS: A total of 292 patients were included. Tumors were classified as low grade in 175 cases (60%), intermediate in 39 (13%) and high grade in 78 (27%). Median follow-up was 26 months. The 5-year OS and DFS rates were respectively 83% and 69%. In multivariate analysis, age (p = 0.004), diabetes (p = 0.02) and advanced stage (p = 0.03) were found to have a significant negative impact on OS. Diabetes (p = 0.001), alcohol consumption (p = 0.003) and advanced stage (p = 0.001) were found to have a significant negative impact on DFS. Compare to low grade, high grade tended to have a negative impact on OS (p = 0.05) and had a significant effect on DFS (0.002) while intermediate grade had no significant influence on survival. The surgical treatment had a positive impact on both OS (p = 0.00005) and DFS (p = 0.0005). Postoperative radiotherapy had no impact in multivariate analysis. CONCLUSION: Advanced clinical stage, high grade tumor, high age, the impossibility of carrying out a complete surgical resection, and diabetes are the main prognostic factors in this prospective series of patients with MEC. Such findings open new research perspectives on the influence of these components on initial patient care.
BACKGROUND: To describe the characteristics of the largest European study of MEC of salivary glands and to determine the prognostic factors for overall and disease free survival. PATIENTS AND METHODS: Patients with MEC were prospectively included in the Réseau d'Expertise Français sur les Cancers ORL Rares (REFCOR, French Network of Rare Head and Neck Tumors) database between 2009 and 2015. RESULTS: A total of 292 patients were included. Tumors were classified as low grade in 175 cases (60%), intermediate in 39 (13%) and high grade in 78 (27%). Median follow-up was 26 months. The 5-year OS and DFS rates were respectively 83% and 69%. In multivariate analysis, age (p = 0.004), diabetes (p = 0.02) and advanced stage (p = 0.03) were found to have a significant negative impact on OS. Diabetes (p = 0.001), alcohol consumption (p = 0.003) and advanced stage (p = 0.001) were found to have a significant negative impact on DFS. Compare to low grade, high grade tended to have a negative impact on OS (p = 0.05) and had a significant effect on DFS (0.002) while intermediate grade had no significant influence on survival. The surgical treatment had a positive impact on both OS (p = 0.00005) and DFS (p = 0.0005). Postoperative radiotherapy had no impact in multivariate analysis. CONCLUSION: Advanced clinical stage, high grade tumor, high age, the impossibility of carrying out a complete surgical resection, and diabetes are the main prognostic factors in this prospective series of patients with MEC. Such findings open new research perspectives on the influence of these components on initial patient care.
Authors: Francesca De Felice; Valentino Valentini; Marco De Vincentiis; Cira Rosaria Tiziana Di Gioia; Daniela Musio; Aida Angela Tummolo; Ludovica Isabella Ricci; Valeria Converti; Silvia Mezi; Daniela Messineo; Gianluca Tenore; Marco Della Monaca; Massimo Ralli; Francesco Vullo; Andrea Botticelli; Edoardo Brauner; Paolo Priore; Romeo Umberto; Paolo Marchetti; Carlo Della Rocca; Antonella Polimeni; Vincenzo Tombolini Journal: In Vivo Date: 2021 Nov-Dec Impact factor: 2.406