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Del Puerto C, Jaque A, Gonzalez-Bombardiere S, Molgó M. Cutaneous Metastasis From Parotid Tumors: A Report of 2 Cases and Literature Review. Am J Dermatopathol 2021; 43:514-520. [PMID: 33534212 DOI: 10.1097/dad.0000000000001893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Cutaneous metastases from parotid tumors are uncommon and imply a poor prognosis. In this article, we report 2 new cutaneous metastasis cases from 2 different parotid malignancies and 42 additional cases from a literature review. Clinical manifestations, localization, and outcomes of skin metastasis from parotid tumors are described. Although infrequent, parotid neoplasms may develop skin metastasis many years after the initial diagnosis, mostly in the head and neck region. Therefore, long-term follow-up and periodic skin examination of these patients is mandatory. Dermatologists and surgeons must have a high index of suspicion when evaluating any skin lesion arising on these patients because cutaneous metastasis from parotid neoplasms generally implies a poor prognosis.
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Affiliation(s)
- Constanza Del Puerto
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; and
| | - Alejandra Jaque
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; and
| | | | - Montserrat Molgó
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; and
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2
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Iodine-125 brachytherapy alone for advanced primary parotid gland carcinoma. Int J Oral Maxillofac Surg 2018; 47:561-567. [DOI: 10.1016/j.ijom.2017.03.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/12/2017] [Accepted: 03/14/2017] [Indexed: 11/20/2022]
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3
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Sawabe M, Ito H, Takahara T, Oze I, Kawakita D, Yatabe Y, Hasegawa Y, Murakami S, Matsuo K. Heterogeneous impact of smoking on major salivary gland cancer according to histopathological subtype: A case-control study. Cancer 2017; 124:118-124. [PMID: 28881386 DOI: 10.1002/cncr.30957] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/18/2017] [Accepted: 07/31/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Major salivary gland cancers (M-SGCs) are rare, and have distinct heterogeneous histopathological subtypes. To the authors' knowledge, no consistent evidence of an association between cigarette smoking and the risk of M-SGCs has appeared to date. Furthermore, evidence of potential heterogeneity in the impact of smoking on histopathological subtypes is scarce, despite the fact that the histopathological subtypes of M-SGC exhibit different genetic features. METHODS The authors conducted a case-control study to investigate the association between smoking and M-SGC by histopathological subtype. Cases were 81 patients with M-SGCs and the controls were 810 age-matched and sex-matched first-visit outpatients without cancer treated at Aichi Cancer Center Hospital from 1988 to 2005. Odds ratios (OR) and 95% confidence intervals (95% CI) were assessed by conditional logistic regression analysis with adjustment for potential confounders. RESULTS Smoking was found to be associated with a significantly increased risk of M-SGC overall, with an OR of 3.45 (95% CI, 1.58-7.51; P =.001) for heavy smokers compared with never-smokers. A significant dose-response relationship was observed (P for trend, .001). When stratified by histological subtype, no obvious impact of smoking was observed among patients with mucoepidermoid carcinoma (MEC). In contrast, smoking demonstrated a significantly increased risk of M-SGCs other than MEC, with an OR of 5.15 (95% CI, 2.06-12.87; P<.001) for heavy smokers compared with never-smokers. The authors observed possible heterogeneity with regard to the impact of smoking on risk between MEC and M-SGCs other than MEC (P for heterogeneity, .052). CONCLUSIONS The results of the current study demonstrate a significant positive association between cigarette smoking and the risk of M-SGC overall. However, the impact of smoking appeared to be limited to M-SGCs other than MEC. Cancer 2018;124:118-24. © 2017 American Cancer Society.
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Affiliation(s)
- Michi Sawabe
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Otolaryngology, Head and Neck Surgery, Nagoya City Univercity Graduate School of Medicine, Nagoya, Japan
| | - Hidemi Ito
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Taishi Takahara
- Department of Surgical Pathology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Isao Oze
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Daisuke Kawakita
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Otolaryngology, Head and Neck Surgery, Nagoya City Univercity Graduate School of Medicine, Nagoya, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shingo Murakami
- Department of Otolaryngology, Head and Neck Surgery, Nagoya City Univercity Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Salivary gland tumours in a northern Chinese population: a 50-year retrospective study of 7190 cases. Int J Oral Maxillofac Surg 2017; 46:343-349. [DOI: 10.1016/j.ijom.2016.09.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/22/2016] [Accepted: 09/22/2016] [Indexed: 12/16/2022]
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5
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Rebours C, Couloigner V, Galmiche L, Casiraghi O, Badoual C, Boudjemaa S, Chauvin A, Elmaleh M, Fresneau B, Fasola S, Garabédian EN, Van Den Abeele T, Orbach D. Pediatric salivary gland carcinomas: Diagnostic and therapeutic management. Laryngoscope 2016; 127:140-147. [PMID: 27497071 DOI: 10.1002/lary.26204] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 06/27/2016] [Indexed: 02/04/2023]
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.
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Affiliation(s)
- Céleste Rebours
- Pediatric Ear, Nose, and Throat Department, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France
| | - Vincent Couloigner
- Pediatric Ear, Nose, and Throat Department, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France
| | - Louise Galmiche
- Department of Pathology, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Institute, Grand Campus, Villejuif, France
| | - Cécile Badoual
- Department of Pathology, Georges Pompidou European Hospital, Public Assistance-Hospitals of Paris, Paris, France
| | - Sabah Boudjemaa
- Department of Pathology, Armand Trousseau Hospital, Public Assistance-Hospitals of Paris, Paris, France
| | - Anthony Chauvin
- Paris Diderot University, Sorbonne Paris Cité, Public Assistance-Hospitals of Paris, Lariboisière Hospital, Emergency Services, Paris, France
| | - Monique Elmaleh
- Department of Radiology, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France
| | - Brice Fresneau
- Pediatric Department, Gustave Roussy Institute, Grand Campus, Villejuif, France
| | - Sylvie Fasola
- Hematology and Oncology Department, Armand Trousseau Hospital, Public Assistance-Hospitals of Paris, Paris, France
| | - Erea-Noël Garabédian
- Pediatric Ear, Nose, and Throat Department, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France
| | - Thierry Van Den Abeele
- Pediatric Ear, Nose, and Throat Department, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France
| | - Daniel Orbach
- Pediatric, Adolescent, and Young Adult Department, Curie Institute, Paris, France
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Kreppel M, Scheer M, Meyer M, Stenner M, Wedemeyer I, Drebber U, Semrau R, Odenthal M, Zöller JE, Guntinas-Lichius O, Büttner R, Beutner D. Comparison of TNM-based stage grouping versus UICC/AJCC stage grouping (7th edition) in malignant parotid gland tumors. Oral Oncol 2013; 49:903-910. [DOI: 10.1016/j.oraloncology.2013.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 05/03/2013] [Accepted: 06/17/2013] [Indexed: 12/12/2022]
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7
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Stodulski D, Mikaszewski B, Stankiewicz C. Are all prognostic factors in parotid gland carcinoma well recognized? Eur Arch Otorhinolaryngol 2011; 269:1019-25. [PMID: 21822857 PMCID: PMC3275734 DOI: 10.1007/s00405-011-1716-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 07/12/2011] [Indexed: 11/27/2022]
Abstract
The aim of his study was to assess the treatment results and prognostic factors in patients with parotid gland carcinoma. The material consisted of 109 patients treated surgically, with or without complementary radiotherapy, between 1978 and 2008 (follow-up at least 5-years). 5-year overall and disease-specific survival were observed in 57.0% of the patients and 5-year disease-free survival was achieved in 50.0%. Univariate analysis including ten clinical and pathological features to assess their prognostic value was done. Parapharyngeal space invasion, facial nerve palsy, and high grade of tumor malignancy were the factors with the highest influence on the treatment results, because their presence decreased the chance for recovery 9.8, 9.7, and 8.2 times, respectively. Histologically positive cervical lymph nodes and extraparenchymal extension were the other factors connected with poor prognosis (prognosis worse 6.7 and 5.4 times, respectively). Clinically positive cervical lymph nodes, positive/uncertain microscopic margin, involvement of the deep lobe, or the whole gland increased the risk of treatment failure 3.4, 3.1, and 2.8, respectively. The age ≥60 years and male gender were statistically significant factors, correlated with poor prognosis and decreased chance for recovery 2.4 and 2.6 times. T-status and clinical stage had important influence on 5-year disease-free survival rate because there were significant differences in the treatment results between individual stages. Multivariate analysis proved that the independent prognostic value, among anatomic structures involved by the neoplasm, had mandible, facial nerve, and skin infiltration. Among tumor-related factors, T-stage and grade had the statistically significant influence on treatment results, and stage and lymph nodes metastases among clinical and pathological features. These results confirm the value of actually used TNM classification (2002). Although the parapharyngeal space invasion is a factor, which seems to have a significant, poor prognostic value, it was not included in this classification.
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Affiliation(s)
- Dominik Stodulski
- Department of Otolaryngology, Medical University of Gdansk, ul. Debinki 7 (Klinika ORL), 80-211, Gdansk, Poland.
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Vander Poorten V, Bradley PJ, Takes RP, Rinaldo A, Woolgar JA, Ferlito A. Diagnosis and management of parotid carcinoma with a special focus on recent advances in molecular biology. Head Neck 2011; 34:429-40. [DOI: 10.1002/hed.21706] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 10/19/2010] [Accepted: 10/26/2010] [Indexed: 11/05/2022] Open
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Vander Poorten VLM, Marchal F, Nuyts S, Clement PMJ. Parotid carcinoma: Current diagnostic workup and treatment. Indian J Surg Oncol 2010; 1:96-111. [PMID: 22930624 PMCID: PMC3421013 DOI: 10.1007/s13193-010-0022-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 04/30/2010] [Indexed: 01/04/2023] Open
Abstract
In this review we present recent progress in diagnostic workup, prognostic evaluation, treatment options and resulting outcomes. Whenever possible, complete resection remains the mainstay of treatment. Sacrifice of facial nerve branches is reserved for the clinically or electromyographically dysfunctioning facial nerve. Clinical or radiological neck disease demands combined surgery and radiotherapy. Treatment of the N0 neck is indicated for advanced stage-high grade tumors but the question remains unanswered whether this should be surgical or radiotherapeutic elective treatment. Surgery alone will cure low stage, low grade tumors, that show no additional negative prognostic factors following adequate resection. In all other tumors postoperative radiotherapy will improve locoregional control. This approach results in good locoregional control, in a way that distant metastasis remains the typical presentation of treatment failure. In this setting, the results of systemic treatment today remain limited, but a huge effort in the molecular biology field has been done to introduce targeted therapy into this domain of head and neck cancer. Disease control remains variable within the patient population. This variation can increasingly be predicted by systems that incorporate the combined information of multivariately identified and quantified prognostic factors into an individualized prognosis for the parotid carcinoma patient.
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Affiliation(s)
- Vincent L. M. Vander Poorten
- Department of Otorhinolaryngology, Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
- European Salivary Gland Society, Geneva, Switzerland
| | - Francis Marchal
- Department of Otorhinolaryngology, Head and Neck Surgery, CHU Geneve and Hôpital Général Beaulieu, European Salivary Gland Society, Geneva, Switzerland
| | - Sandra Nuyts
- Department of Radiotherapy-Oncology and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
| | - Paul M. J. Clement
- Department of Medical Oncology and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
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11
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Schroeder U, Groppe D, Mueller RP, Guntinas-Lichius O. Parotid cancer: Impact of changes from the 1997 to the 2002 American Joint Committee on Cancer classification on outcome prediction. Cancer 2008; 113:758-64. [DOI: 10.1002/cncr.23626] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lim YC, Lee SY, Kim K, Lee JS, Koo BS, Shin HA, Choi EC. Conservative parotidectomy for the treatment of parotid cancers. Oral Oncol 2005; 41:1021-7. [PMID: 16129655 DOI: 10.1016/j.oraloncology.2005.06.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2005] [Accepted: 06/05/2005] [Indexed: 11/23/2022]
Abstract
A conservative parotidectomy is defined as any procedure that is less than a classic superficial parotidectomy, and where less than a full facial nerve is dissected. The aim of this study was to evaluate the oncologic effects of a conservative parotidectomy in a series of patients with malignant tumors of the parotid gland. The medical records of 43 patients treated at Severance Hospital from 1992 to 2002 who had been diagnosed with parotid cancers confined to the superficial lobe, and had also undergone conservative parotidectomies were reviewed. There were 16 males and 27 females, ranging in age from 8 to 84 years. Sixteen tumors (37%) were high-grade and 27 tumors (63%) were low-grade cancers. Twenty-four patients underwent neck dissection simultaneously with the primary lesion. Surgical treatment was followed by radiotherapy in 10 patients. The follow-up period ranged from 8 to 130 months, with a mean duration of time at 57.7 months. The overall survival rate and the disease-free rate at five years were 88% and 79%, respectively. Univariate analyses showed histologic tumor grade (p = 0.003) and pathologic neck node metastasis (p < 0.001) to be significant variables. Based on multivariate analysis, only the presence of pathologically positive lymph nodes proved to be significant (p = 0.001). Occult metastases rates was 25% (3 of 12 cases) for high-grade tumors and none of the low-grade tumors had microscopic metastases. Recurrences developed in eight cases (19%). Four cases (9%) had a local or locoregional failure. Of these cases, two cases were high-grade tumors (13%, 2 of 16) and the other two cases were low-grade tumors (7%, 2 of 27). The six cases (14%) of which four cases were high-grade (25%) and two cases were low-grade (7%) had positive surgical margin but showed no evidence of local recurrence after additional postoperative radiotherapy. The incidence of postoperative facial nerve paralysis (HB > 1) was 12% (5 out of 43) for a temporary deficit, but there was no permanent paralysis. Conservative parotidectomy with appropriate postoperative radiotherapy may be an acceptable procedure without potential morbidity, such as postoperative facial palsy, in the treatment of low-grade parotid cancers confined to the superficial lobe if the facial nerve is sufficiently distant from the tumor.
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Affiliation(s)
- Young Chang Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University College of Medicine, Seoul, Korea
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Terhaard CHJ, Lubsen H, Van der Tweel I, Hilgers FJM, Eijkenboom WMH, Marres HAM, Tjho-Heslinga RE, de Jong JMA, Roodenburg JLN. Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck 2005; 26:681-92; discussion 692-3. [PMID: 15287035 DOI: 10.1002/hed.10400] [Citation(s) in RCA: 331] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We analyzed the records of patients with malignant salivary gland tumors, as diagnosed in centers of the Dutch Head and Neck Oncology Cooperative Group, in search of independent prognostic factors for locoregional control, distant metastases, and overall survival. METHODS In 565 patients, we analyzed general results and looked for the potential prognostic variables of age, sex, delay, clinical and pathologic T and N stage, site (332 parotid, 76 submandibular, 129 oral cavity, 28 pharynx/larynx), pain, facial weakness, clinical and pathologic skin involvement, histologic type (WHO 1972 classification), treatment, resection margins, spill, perineural and vascular invasion, number of neck nodes, and extranodal disease. The median follow-up period was 74 months; it was 99 months for patients who were alive on the last follow-up. RESULTS The rates of local control, regional control, distant metastasis-free and overall survival after 10 years were, respectively, 78%, 87%, 67%, and 50%. In multivariable analysis, local control was predicted by clinical T-stage, bone invasion, site, resection margin, and treatment. Regional control depended on N stage, facial nerve paralysis, and treatment. The relative risk with surgery alone, compared to surgery plus postoperative radiotherapy, was 9.7 for local recurrence and 2.3 for regional recurrence. Distant metastases were independently correlated with T and N stage, sex, perineural invasion, histologic type, and clinical skin involvement. Overall survival depended on age, sex, T and pN stage, site, skin and bone invasion. CONCLUSIONS Several prognostic factors for locoregional control, distant metastases, and overall survival were found. Postoperative radiotherapy was found to improve locoregional control.
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Affiliation(s)
- Chris H J Terhaard
- Department of Radiotherapy of the UMC Utrecht, Heidelberglaan 100, 3583 CX, Utrecht, The Netherlands
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Luukkaa H, Klemi P, Leivo I, Koivunen P, Laranne J, Mäkitie A, Virtaniemi J, Hinkka S, Grénman R. Salivary gland cancer in Finland 1991--96: an evaluation of 237 cases. Acta Otolaryngol 2005; 125:207-14. [PMID: 15880955 DOI: 10.1080/00016480510003174] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
CONCLUSION In this material consisting of various salivary gland carcinomas, stage I, male gender and age were the most powerful predictors of patient outcome. OBJECTIVES To retrieve the records of all salivary gland cancer (SGC) patients diagnosed in Finland between 1991 and 1996 and to evaluate the incidence, histological type and location of SGC, the treatment given and the outcome. MATERIAL AND METHODS The records for all SGCs (n =286) diagnosed in Finland between 1991 and 1996 and reported to the Finnish Cancer Registry were retrieved. The histological re-evaluation and retrospective study involved 237 SGC patients. RESULTS The study population consisted of 125 males and 112 females. The mean age was 59 years (males 61 years, females 58 years). Follow-up was at least 5 years. The commonest tumor location was the parotid gland (n = 152; 64%), followed by the minor salivary glands (n =46; 19%), the submandibular gland (n =38; 16%) and the sublingual gland (n = 1; 0.4%). The most frequent histological types of SGC were adenoid cystic carcinoma (n =65; 27%), mucoepidermoid carcinoma (n =45; 19%) and acinic cell carcinoma (n =41; 17%). Surgery, either alone or in combination with other treatment modalities, was used in 209 cases (88%). Radiotherapy was given to 136 patients (57%), 13 of whom (5%) did not undergo surgery. The 5-year overall survival rate was 56.5%, and for stages I-IV it was 78%, 25%, 21% and 23%, respectively (p <0.001; log-rank test). Of the commonest tumor types, the best 5-year relative survival rate was for patients with acinic cell carcinoma (96%), followed by those with mucoepidermoid (79%) and adenoid cystic carcinoma (74%).
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Affiliation(s)
- Heikki Luukkaa
- Department of Otorhinolaryngology--Head and Neck Surgery, University of Turku, Turku, Finland
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Kokemueller H, Swennen G, Brueggemann N, Brachvogel P, Eckardt A, Hausamen JE. Epithelial malignancies of the salivary glands: clinical experience of a single institution—a review. Int J Oral Maxillofac Surg 2004; 33:423-32. [PMID: 15183404 DOI: 10.1016/j.ijom.2004.02.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2004] [Indexed: 11/24/2022]
Abstract
In this retrospective study we give a clinical review of our experience with different subtypes of salivary gland cancer. Between January 1983 and December 2002, a total of 155 patients with carcinomas of the salivary glands received initial treatment at the Department of Oral and Maxillofacial Surgery, Hanover Medical School. There were 79 (51.0%) adenoid cystic carcinomas, 42 (27.1%) mucoepidermoid carcinomas, 12 (7.7%) adenocarcinomas, 10 (6.5%) polymorphous adenocarcinomas and 12 (7.7%) other tumor entities of smaller number. Complete resection was reached for 63.5% of patients with high grade carcinomas and for 80.0% of patients with low grade carcinomas. 26.2% of patients with high grade carcinomas and 13.3% of patients with low grade carcinomas received postoperative radiation. Overall survival rates at 5, 10 and 15 years were 65.9, 48.0 and 39.8% with significant difference for patients with high grade and low grade carcinomas. Histopathologic subtype, tumor stage and margin status significantly influenced prognosis. Statistically, we were not able to demonstrate a positive effect for postoperative radiation. In the future, patients with salivary gland carcinomas should be randomised for prospective multicentric clinical trials, which could provide reliable information about adjuvant treatment modalities and their results even for rare subtypes of salivary gland cancer.
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Affiliation(s)
- H Kokemueller
- Department of Oral and Maxillofacial Surgery, Hanover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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Kokemüller H, Brüggemann N, Brachvogel P, Eckardt A. [Malignant epithelial salivary gland tumors. Clinical review of 2 decades]. ACTA ACUST UNITED AC 2004; 8:191-201. [PMID: 15138857 DOI: 10.1007/s10006-004-0531-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE In this retrospective study we give a clinical review of our experience with different tumor entities of salivary gland cancer. PATIENTS Between January 1983 and December 2002, a total of 155 patients with carcinomas of the salivary glands received initial treatment at the Department of Oral and Maxillofacial Surgery, Hanover Medical School. RESULTS There were 51.0% adenoid cystic carcinomas, 27.1% mucoepidermoid carcinomas, 7.7% adenocarcinomas, 6.5% polymorphous adenocarcinomas, and altogether 7.7% other less frequent tumor entities. Complete resection was achieved for 63.5% of patients with high-grade carcinomas and for 80.0% of patients with low-grade carcinomas. Postoperative radiation was administered to 26.2% of patients with high-grade carcinomas and 13.3% of patients with low-grade carcinomas. Overall local control rates at 5, 10, and 15 years were 77.5%, 66.2%, and 59.0%. Overall regional control rates at 5, 10, and 15 years were 93.5%, 87.6%, and 85,4%. Overall distant control rates at 5, 10, and 15 years were 85.9%, 77,2%, and 73,6%. Overall survival rates at 5, 10, and 15 years were 65,9%, 48,0%, and 39,8%. There was a significant difference between patients with low-grade and high-grade carcinomas. Polymorphous adenocarcinomas showed the best prognosis, followed by low-grade mucoepidermoid carcinomas, adenoid cystic carcinomas, adenocarcinomas, and high-grade mucoepidermoid carcinomas. The number of the remaining tumor entities was too small to be divided into independent subgroups for statistical analysis. Tumor entity, tumor stage, and margin status significantly influenced prognosis. Statistically, we were not able to demonstrate a positive effect for postoperative radiation. CONCLUSION Grading is important, but should be considered in the context of stage. In the future, patients with salivary gland carcinomas should be randomized for prospective multicenter clinical trials, which could provide reliable information about adjuvant treatment modalities and their results even for rare subtypes of salivary gland cancer.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Adenoid Cystic/mortality
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/radiotherapy
- Carcinoma, Adenoid Cystic/surgery
- Carcinoma, Mucoepidermoid/mortality
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Mucoepidermoid/radiotherapy
- Carcinoma, Mucoepidermoid/surgery
- Carcinoma, Renal Cell/mortality
- Carcinoma, Renal Cell/pathology
- Carcinoma, Renal Cell/radiotherapy
- Carcinoma, Renal Cell/surgery
- Child
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Neoplasms, Glandular and Epithelial/mortality
- Neoplasms, Glandular and Epithelial/pathology
- Neoplasms, Glandular and Epithelial/radiotherapy
- Neoplasms, Glandular and Epithelial/surgery
- Radiotherapy, Adjuvant
- Retrospective Studies
- Salivary Gland Neoplasms/mortality
- Salivary Gland Neoplasms/pathology
- Salivary Gland Neoplasms/radiotherapy
- Salivary Gland Neoplasms/surgery
- Survival Rate
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Affiliation(s)
- H Kokemüller
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover.
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Przewoźny T, Stankiewicz C. Neoplasms of the parotid gland in northern Poland, 1991–2000: an epidemiologic study. Eur Arch Otorhinolaryngol 2003; 261:369-75. [PMID: 14586626 DOI: 10.1007/s00405-003-0698-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2002] [Accepted: 09/09/2003] [Indexed: 12/01/2022]
Abstract
A review of patients treated for malignant and benign parotid tumors in a 10-year period (1991-2000) in the Pomeranian County of Poland revealed 417 new cases. The age-standardized incidence rate was 0.23 and 1.35 per 100,000 inhabitants for malignant and benign tumors, respectively. The following data were collected: age, sex, place of living, education, job, smoking, symptoms, duration of symptoms at the time of diagnosis, result of histopathological tumor examination, tumor size, TNM staging and distant metastases. The results were divided into two parts: malignant neoplasms and benign neoplasms. The most common malignant neoplasms were carcinomas (96.8%), and among them the most numerous were mucoepidermoid carcinoma (22.2%), carcinoma in pleomorphic adenoma (20.6%) and adenoid cystic carcinoma (15.9%). The most common benign neoplasms were adenomas (95.5%), most frequently pleomorphic adenoma (65.5%) and adenolymphoma (24.0%), but rarely basal cell adenoma (4.2%). We also observed a steady increase in the number of benign parotid tumors in the examined period of time.
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Affiliation(s)
- Tomasz Przewoźny
- ENT Department, Medical University of Gdansk, 7 Debinki Street, 80-211 Gdansk, Poland.
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Abstract
BACKGROUND The low incidence and heterogeneity of histiotypes of primary parotid carcinomas makes these tumors histologically and epidemiologically difficult to evaluate. The present study reviews a single institution's experience in the treatment of primary parotid carcinomas during the last 10 years. METHODS The charts of 98 consecutive patients who had a primary parotid carcinoma and who received primary curative treatment were analyzed retrospectively. The tumors were grouped into high-grade and low-grade malignancies. The effect of treatment modalities on locoregional control, the incidence of locoregional recurrences and distant metastases, and survival rates are evaluated and compared between high- and low-grade malignancies. RESULTS High- and low-grade malignant tumors were observed in 50 and 48 cases, respectively. Lymph node metastases were detected in 25 of 98 (25%) patients, of whom 8 of 22 (22%) clinically NO staged patients underwent elective neck dissection. In 24 of 26 resected facial nerves, a histologic tumor infiltration was confirmed, in 14 high-grade and 10 low-grade tumors. Local recurrence developed in 13 patients and was associated in 7 with high-grade and in 6 with low-grade tumors. All but 1 of the low-grade malignancies with local recurrence did not receive postoperative irradiation. Regional recurrence developed in 11 patients and distant metastases developed in 10, 3 in combination with a neck recurrence and 1 with a local recurrence. The survival rate at 5 years for low- and high-grade carcinomas was 87% and 56% and the disease-free survival rate 72% and 48%, respectively. CONCLUSIONS The incidence of occult metastases in clinically N0-elective neck dissection was 22%. A routine elective neck dissection in all N0 parotid carcinomas is suggested. There is no statistically significant difference between low- and high-grade tumors as for the rate of local recurrence and, as all except one of the low-grade malignancies with local recurrence did not receive postoperative irradiation, postoperative irradiation is not only suggested for high-grade carcinomas but also for T2 to T4 low-grade carcinomas.
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Affiliation(s)
- Peter Zbären
- Department of Oto-Rhino-Laryngology, Head, and Neck Surgery, University Hospital, CH-3000 Berne, Switzerland.
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Vander Poorten VLM, Hart AAM, van der Laan BFAM, Baatenburg de Jong RJ, Manni JJ, Marres HAM, Meeuwis CA, Lubsen H, Terhaard CHJ, Balm AJM. Prognostic index for patients with parotid carcinoma: external validation using the nationwide 1985-1994 Dutch Head and Neck Oncology Cooperative Group database. Cancer 2003; 97:1453-63. [PMID: 12627510 DOI: 10.1002/cncr.11254] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Validation of the prognostic indices for the recurrence-free interval of patients with parotid carcinoma, the development of which was described in a previous report, is needed to be confident of their generalizability and justified prospective use. METHODS The Dutch Cooperative Group on Head and Neck Cancer database contains 231 patients with parotid carcinoma from six tertiary referral centers who were seen between 1985-1994. This database was used to validate the predictive value of the prognostic indices, PS1 (pretreatment index predicting recurrence) and PS2 (posttreatment index predicting recurrence), in patients with parotid carcinoma. Validation methods included calculation of both indices for each patient, comparison of coefficients, construction of survival curves using the published cutoff points, and calculation of concordance measure C. Wald tests for optimization of scale and weights of the contributing variables, and for possible score improvement by including other variables, were also performed. RESULTS The 5-year disease-free rate was 62% (standard error = 4%). PS1 was calculated for 183 patients. The previously set cutoff points resulted in 5-year disease-free rates that ranged from 92% (PS1 = 1) to 42% for the least favorable group (PS1 = 4). Concordance measure C was 0.74. The postoperative score, PS2, was calculated for 171 patients. Previous cutoff points resulted in 5-year disease-free rates that ranged from 90% (PS2 = 1) to 40% (PS2 = 4). Concordance measure C was 0.71. Both PS1 and PS2 did not improve using the findings in this independent material. CONCLUSIONS The prognostic indices performed adequately in this validation sample. This finding demonstrates that the prognosis of a parotid carcinoma patient can be quantified by using a weighted combination of the parameters of age, pain, clinical T (cT) classification, clinical N (cN) classification, skin invasion, facial nerve dysfunction, perineural growth, and involved surgical margins. A quantified prognosis, in terms of the recurrence-free interval, can be used to provide information to the patient, to perform clinical trials, and eventually to make clinical decisions. A user-friendly translation and computerized calculation of the indices should be the next step toward generalized prospective use and repetitive evaluation of the indices.
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Affiliation(s)
- Vincent L M Vander Poorten
- Department of Head and Neck Oncology of the Netherlands' Cancer Institute (NKI/AvL), Amsterdam, The Netherlands.
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