1
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Liu L, Xiang Y, Shui C, Li C, Xiong L, Hu J, Ai H, Zhou Y, Jiang J, Cai Y. Long-term follow-up and prognostic analysis of parotid tumors in children and adolescents. Laryngoscope Investig Otolaryngol 2024; 9:e1275. [PMID: 38835331 PMCID: PMC11149764 DOI: 10.1002/lio2.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives The objective of this study is to summarize the clinical characteristics, treatment, and prognosis of parotid tumors in children and adolescents. Methods Fifty-three children and adolescents diagnosed with parotid gland tumors were included. Survival was evaluated using the Kaplan-Meier method. Log-rank test and multivariate analysis were used to analyze the association between clinical factors and recurrence. Results Of the 53 patients, 30 cases were benign and 23 cases were malignant. All patients underwent surgery. Patients with malignant tumors with high-risk factors received radiotherapy or chemotherapy. The median follow-up time was 61 months. Of these, 1 patient with benign tumor and 5 patients with malignant tumors recurred. Of the patients with malignant tumors, 2 developed distant metastases and 2 died. The 5-year overall survival (OS) and 5-year locoregional recurrence-free survival (LRFS) rates for benign tumors were 100.0% and 92.9%, respectively, whereas the 5-year OS and 5-year LRFS rates for malignant tumors were 94.4% and 72.5%, respectively. The log-rank univariate test showed that tumor size >3.5 cm (p = .056), distant metastasis (p = .056), and stage III and IV (p = .032) were associated with recurrence. However, multivariate analysis did not show the above factors to be independent prognostic factors for LRFS. Conclusion Surgery for benign tumors depends on the location and size. Surgery for malignant parotid tumors depends mainly on the stage, grade, pathological type, and recurrence. Prophylactic lymph node dissection is required for high-grade tumors. Radiotherapy or chemotherapy for children needs more research. Both benign and malignant tumors have high survival rates after active treatment. Level of evidence Level 2.
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Affiliation(s)
- Lei Liu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Yuqing Xiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Chunyan Shui
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Lujing Xiong
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Jinchuan Hu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Hao Ai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- Graduate School Chengdu Medical College Chengdu China
| | - Yuqiu Zhou
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Jian Jiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
| | - Yongcong Cai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China
- School of Medicine University of Electronic Science and Technology of China Chengdu China
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2
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Hou X, Liang F, Lou Y. Clinical features and prognostic factors for malignant parotid tumors in children and adolescents: A population-based study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 125:101741. [PMID: 38104649 DOI: 10.1016/j.jormas.2023.101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE We performed a population-based cohort study to investigate the clinical characteristics and survival rates of primary malignant parotid tumors (MPT) in children and adolescents. METHODS The Surveillance, Epidemiology, and End Results (SEER) database was used to identify all pediatric and adolescent patients with MPT who were diagnosed between 2000 and 2018. Based on a number of parameters, survival curves were produced using Kaplane-Meier estimates. The log-rank test was used to compare survival curves. The influence of each component on overall survival (OS) was examined using a multivariate Cox proportional hazards model. RESULTS There were 352 identified pediatric and adolescent patients with MPT. At diagnosis, the age ranged from 1.0 to 19 years, with a median of 15 years. Mucoepidermoid carcinoma (MC) (46.5 %) was the most common histological subtype, followed by acinar cell carcinoma (ACC) (36.4 %) and others (17.1 %) such as adenoid cystic carcinoma and squamous cell carcinoma. All patients had overall survival rates of 98.8 %, 95.6 %, and 94.6 % at 1-year, 3-year and 5-year, respectively. The results of the Cox proportional hazard regression showed that tumor grade, SEER stage, radiotherapy, and treatment regimens were significant independent predictors of overall survival. CONCLUSIONS In pediatric and adolescent MPT, tumor grade, SEER stage, adjuvant radiation, and treatment regimens were found to be important independent predictors of survival. More research is required to validate the role of adjuvant radiation.
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Affiliation(s)
- Xiapei Hou
- Department of Stomatology, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
| | - Fuhua Liang
- Department of Pediatric Surgery, Nanning Maternity and Child Health Hospital, Nanning, Guangxi, China
| | - Yi Lou
- Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China.
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3
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Coleman M, Liang J, Rastatter JC, Arch RS, Gartrell J, Chelius DC, Sheyn A, Li C, Richard C. Exploring the Epidemiology and Survival Trends in Pediatric Major Salivary Gland Malignancies: Insights from the National Cancer Database. Curr Oncol 2023; 30:6134-6147. [PMID: 37504316 PMCID: PMC10378439 DOI: 10.3390/curroncol30070456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/07/2023] [Accepted: 06/17/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE To investigate the clinicopathological, therapeutic, and survival data on pediatric major salivary gland cancers. MATERIALS AND METHODS National Cancer Database (NCDB) query from 2004 to 2018. RESULTS In total, 967 cases of individuals under the age of 21 were identified. Most cancers affected the parotid gland (86%). Mucoepidermoid carcinoma (41.3%) and acinic cell adenocarcinoma (33.6%) were the most common. Tumors occurred more often from age 11 to 21, and females were more affected. Histology varied by age, gender, and race. In the 0-5 age group, mucoepidermoid carcinoma and myoepithelial carcinoma/sarcoma/rhabdomyosarcoma were the most common pathologies. In patients over 5 years old, mucoepidermoid carcinoma was the most frequent tumor in boys, while acinic cell adenocarcinoma was more common in girls. African American patients had a higher incidence of mucoepidermoid carcinoma, while White patients in the 0-5 age group had a higher incidence of myoepithelial carcinoma/sarcoma/rhabdomyosarcoma tumors. Low-grade tumors were commonly diagnosed at stage I, but the 0-5 age group had a high frequency of stage IV tumors. The overall 5-year survival rate was 94.9%, with 90% for the 0-5 years age group and 96% for the 11-15 years age group. Negative margins were associated with higher 5-year survival rates in high-stage tumors (93%) compared to positive margins (80%). Submandibular malignancies had worse 5-year survival rates across all age groups. CONCLUSIONS Major salivary gland malignancies in pediatric patients exhibit variations in histopathologic characteristics by age, gender, and race. Negative margins impact 5-year survival rates, especially in high-stage tumors.
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Affiliation(s)
- Madison Coleman
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38103, USA
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN 38103, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Jia Liang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Jeffrey C Rastatter
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Rebecca S Arch
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jessica Gartrell
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Daniel C Chelius
- Department of Otolaryngology-Head and Neck Surgery, Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA
| | - Anthony Sheyn
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38103, USA
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN 38103, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Cai Li
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Celine Richard
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38103, USA
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN 38103, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
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4
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Lopez J, Chen YH, Eagan A, Fitzgerald C, Woods R, Wong R, Shah J, Ganly I. Surgical management of pediatric salivary malignant tumors-A single-center cohort study. J Surg Oncol 2022; 126:1389-1395. [PMID: 35969241 PMCID: PMC10251410 DOI: 10.1002/jso.27063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to report incidence, clinicopathologic behavior, management, and outcome of pediatric patients treated surgically for salivary gland (SG) malignancies. METHODS Patients who underwent surgery for SG malignancies from 1985 to 2015 were identified. Clinical, pathological, treatment and outcomes data were collected. Disease-specific survival (DSS), recurrence-free survival (RFS), and overall survival (OS) were calculated using Kaplan-Meier method. RESULTS Twenty-eight pediatric patients were included. The most common histopathological types were mucoepidermoid (n = 18, 64.3%), acinic cell (n = 7, 25.0%), adenoid cystic (n = 2, 7.1%), and adenocarcinoma (n = 1, 3.6%). Surgical approach varied and ranged from superficial parotidectomy (n = 11, 39.3%) to partial maxillectomy (n = 6, 21.4%). Nine patients (32%) required postoperative radiotherapy. DSS, OS, and RFS probability at 5 years were 96.4%, 96.4%, and 89.3%, respectively. CONCLUSION Pediatric SG malignancies are rare and have favorable outcome at 5 years. Larger, multi-institutional studies are required to better understand the natural history of these rare tumors.
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Affiliation(s)
- Joseph Lopez
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Division of Pediatric Head & Neck Surgery, AdventHealth For Children, Orlando, Florida, USA
| | - Yu Han Chen
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alana Eagan
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Conall Fitzgerald
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robbie Woods
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard Wong
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jatin Shah
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ian Ganly
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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5
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Ajiya A, Shuaibu IY, Yahuza MA. Advance oropharyngeal mucoepidermoid carcinoma in a 9-year-old boy: A case report and review of literature. Afr J Paediatr Surg 2022; 19:105-108. [PMID: 35017381 PMCID: PMC8809470 DOI: 10.4103/ajps.ajps_133_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Primary malignant salivary gland tumours are uncommon among the paediatric population, accounting for <10% of all head-and-neck tumours in childhood. Less than 5% of all salivary gland cancers occur during childhood, most of them are diagnosed over the age of 10 years and are histologically low or intermediate grade. Mucoepidermoid carcinoma (MEC) occurring in the oropharynx of children and arising from the posterior pharyngeal wall is rare and probably never reported. We hereby report a case of advanced MEC arising from the posterior wall of the oropharynx in a 9-year-old boy, managed via a transcervical excision in a resource-poor setting.
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Affiliation(s)
- Abdulrazak Ajiya
- Department of Otorhinolaryngology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
| | - Iliyasu Yunusa Shuaibu
- Department of Surgery, Division of Otorhinolaryngology, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Mansur Adamu Yahuza
- Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
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6
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Surun A, Schneider DT, Ferrari A, Stachowicz-Stencel T, Rascon J, Synakiewicz A, Agaimy A, Martinova K, Kachanov D, Roganovic J, Bien E, Bisogno G, Brecht IB, Kolb F, Thariat J, Moya-Plana A, Orbach D. Salivary gland carcinoma in children and adolescents: The EXPeRT/PARTNER diagnosis and treatment recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29058. [PMID: 34174160 DOI: 10.1002/pbc.29058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/13/2023]
Abstract
Salivary gland carcinomas (SGCs) are rare during childhood and adolescence. Consequently, no standardized recommendations for the diagnosis and therapeutic management of pediatric SGC are available, and pediatric oncologists and surgeons generally follow adult guidelines. Complete surgical resection with adequate margins constitutes the cornerstone of treatment. However, the indications and modalities of adjuvant therapy remain controversial and may be challenging in view of the potential long-term toxicities in the pediatric population. This paper presents the consensus recommendations for the diagnosis and treatment of children and adolescents with SGCs, established by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) within the EU-funded PARTNER project (Paediatric Rare Tumours Network - European Registry).
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Affiliation(s)
- Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | | | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Jelena Rascon
- Center for Pediatric Oncology and Hematology, Vilnius University Hospital, Vilnius, Lithuania
| | - Anna Synakiewicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Kata Martinova
- Department of Hematology and Oncology, University Clinic for Children's Diseases, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Denis Kachanov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Jelena Roganovic
- Department of Pediatrics, Clinical Hospital Center, Rijeka, Croatia
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padua, Italy
| | - Ines B Brecht
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard-Karls-Universitaet Tuebingen, Tübingen, Germany
| | - Frédéric Kolb
- Department of Surgery, Division of Plastic Surgery, University of California, San Diego, California, USA
| | - Juliette Thariat
- Radiation Oncology Department, Baclesse Cancer Center, Caen, France
| | - Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave-Roussy Cancer Campus, Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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7
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Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
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Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
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8
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Diagnosis and management of pediatric epithelial salivary gland malignancy. Curr Opin Otolaryngol Head Neck Surg 2020; 28:443-448. [PMID: 33074951 DOI: 10.1097/moo.0000000000000667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW Salivary tumors are uncommon among children but are more likely to be malignant compared with adults. A lack of experience makes consensus in treatment elusive. Amidst recent publication of large institutional and national series, this review aims to discuss the epidemiology, diagnosis, investigation, and treatment for pediatric epithelial salivary malignancies. RECENT FINDINGS Pediatric salivary malignancies are often low grade and carry a favorable prognosis. High-grade tumors portend an increased risk of recurrence and a decreased survival. Surgeons should strive for oncologic resection with clear margins and avoid enucleation and excisional biopsies. Overt nodal metastases require concurrent neck dissection, whereas elective neck dissections may be reserved for cases with high risk of occult disease, such as advanced stage and high-grade neoplasms. Adjuvant radiation should be considered in high-grade tumors. SUMMARY The paucity of high-level evidence clouds treatment decisions and further encourages pediatric salivary malignancies to be treated in an experienced center with a multidisciplinary approach.
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9
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Zamani M, Grønhøj C, Schmidt Jensen J, von Buchwald C, Charabi BW, Hjuler T. Survival and characteristics of pediatric salivary gland cancer: A systematic review and meta-analysis. Pediatr Blood Cancer 2019; 66:e27543. [PMID: 30378272 DOI: 10.1002/pbc.27543] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/18/2018] [Accepted: 10/17/2018] [Indexed: 01/07/2023]
Abstract
A systematic search of PubMed, EMBASE, and the Cochrane Library for studies from 2000 to 2017 including children aged 0-19 with salivary gland cancer was performed. In 19 studies, 749 children (median age of 14.2 years, female to male ratio of 1.4:1) were included; 72% had parotid tumors and 95% underwent surgery, of whom 65% had surgery alone and 24% with adjuvant radiotherapy. Low-grade and stage mucoepidermoid carcinoma were the most frequent cancer. The 5-year overall- and disease-free survival was 94% and 83%. Recurrence was observed in 20% at a median of 1.1 years from diagnosis.
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Affiliation(s)
- Martin Zamani
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Schmidt Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Wittenborg Charabi
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Hjuler
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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10
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Vargas Gamarra MF, Perolada Vilmaña JM, Armengot Carceller M. Low Grade Mucoepidermoid Carcinoma of a Minor Salivary Gland of the Tongue in a Paediatric Patient. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2017.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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11
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Wu WJ, Huang MW, Zhang GH, Zhao D, Zheng L, Yu GY, Zhang JG. Mandibular growth in survivors of pediatric parotid gland carcinoma treated with interstitial brachytherapy. Pediatr Blood Cancer 2018; 65:e27223. [PMID: 29797637 DOI: 10.1002/pbc.27223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of the study was to present long-term results of mandibular growth in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. PROCEDURE Twenty-five survivors of pediatric parotid gland carcinoma treated with iodine-125 seed interstitial brachytherapy were included for quantitative analysis, including three dimensional (3D) cephalometry and measurement of mandibular volume. RESULTS 3D cephalometry showed that the median fore-and-aft increments of the lengths of the condyle, the ramus, and the body of the mandible were 1.23, 0.19, and 1.66 mm for the affected side, respectively, and were 1.37, 1.95, and 3.42 mm for the unaffected side, respectively. The difference in increments of the ramus was statistically significant between the affected side and the unaffected side (P = 0.003; P < 0.05). Moreover, mandibular volume measurements showed that the median fore-and-aft increments of the volumes of the condyle, the ramus, and the body of the mandible were 290.62, 220.14, and 1706.40 mm3 for the affected side, respectively, and were 269.15, 370.40, and 1469.86 mm3 for the unaffected side, respectively. The difference in increments was statistically significant between the affected side and the unaffected side for the ramus (P = 0.005; P < 0.05) and the body (P = 0.043; P < .05). CONCLUSION Mandibular growth was affected by interstitial brachytherapy, especially for the ramus, in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. Nevertheless, the impact was mild in these survivors.
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Affiliation(s)
- Wen-Jie Wu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Ming-Wei Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Guo-Hao Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Dan Zhao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Lei Zheng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Jian-Guo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
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12
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Thielker J, Grosheva M, Ihrler S, Wittig A, Guntinas-Lichius O. Contemporary Management of Benign and Malignant Parotid Tumors. Front Surg 2018; 5:39. [PMID: 29868604 PMCID: PMC5958460 DOI: 10.3389/fsurg.2018.00039] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/30/2018] [Indexed: 12/25/2022] Open
Abstract
To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors. Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors. Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes. The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.
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Affiliation(s)
- Jovanna Thielker
- Department of Otorhinolaryngology, Universitätsklinikum Jena, Jena, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Stephan Ihrler
- Laboratory for Dermatohistology and Oral Pathology, Munich, Germany
| | - Andrea Wittig
- Department of Radiotherapy and Radiation Oncology, Universitätsklinikum Jena, Jena, Germany
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13
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Morse E, Fujiwara RJT, Husain Z, Judson B, Mehra S. Pediatric Salivary Cancer: Epidemiology, Treatment Trends, and Association of Treatment Modality with Survival. Otolaryngol Head Neck Surg 2018; 159:553-563. [PMID: 29688836 DOI: 10.1177/0194599818771926] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective To characterize the epidemiology of pediatric salivary cancer and associate patient, tumor, and treatment factors with treatment modality and survival. Study Design Cross-sectional analysis. Setting US national database. Subjects and Methods We identified 588 patients 19 years or younger diagnosed with salivary cancer in the National Cancer Database 2004-2013. We characterized patient, tumor, and treatment factors as proportions and associated these factors with treatment modality and overall survival via multivariable logistic regression and multivariable Cox proportional hazards regression, respectively. Results In total, 588 patients were included. Mucoepidermoid carcinoma was identified in 234 of 588 patients (40%) and acinar cell carcinoma in 215 of 588 (37%). Parotid tumors were seen in 504 (86%) of patients. Surgery alone was used to treat 351 (60%) of patients; surgery plus adjuvant radiation was used to treat 145 (25%). Overall 5-year survival was 93%. Controlling for patient and tumor characteristics, treatment with surgery and radiation vs surgery alone was associated with improved overall survival (hazard ratio [HR] = 0.15; 95% confidence interval [CI], 0.02-0.92; P = .041). High tumor grade was associated with decreased overall survival (HR = 33.17; 95% CI, 5.89-186.8; P < .001). Treatment with surgery plus radiation remained associated with improved overall survival in the subset of patients with high tumor grade (HR = 0.12; 95% CI, 0.02-0.64; P = .014). Conclusion Tumor grade is an important predictor of survival in pediatric patients with salivary gland cancer. Surgery plus adjuvant radiation vs surgery alone is associated with improved overall survival and may be considered for high-risk patients, particularly those with high-grade tumors.
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Affiliation(s)
- Elliot Morse
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rance J T Fujiwara
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Zain Husain
- 2 Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Benjamin Judson
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,3 Yale Cancer Center, New Haven, Connecticut, USA
| | - Saral Mehra
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,3 Yale Cancer Center, New Haven, Connecticut, USA
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Janz TA, Camilon PR, Nguyen SA, Levi JR, Lentsch EJ. Has the management of pediatric mucoepidermoid carcinoma of the parotid gland changed? Laryngoscope 2018; 128:2408-2414. [PMID: 29658113 DOI: 10.1002/lary.27192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/16/2018] [Accepted: 02/27/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVES/HYPOTHESIS To examine the evolving changes in management of pediatric mucoepidermoid carcinoma of the parotid gland. STUDY DESIGN Retrospective analysis of a large population database. METHODS Pediatric patients in the Surveillance, Epidemiology, and End Results database were included from 1973 to 2014 based on a diagnosis of mucoepidermoid carcinoma of the parotid gland using the International Classification of Diseases for Oncology, Third Edition codes: C07.9: parotid gland and 8430/3: mucoepidermoid carcinoma. Patients were included from ages 0 to 18 years. Patients were categorized into 5- or 6-year cohorts based on their year of diagnosis. Two-year and 5-year survival was calculated using actuarial or life-table analysis. RESULTS One hundred sixty-nine pediatric cases were identified. Eighty of the 169 cases (47.4%) were diagnosed from 2005 to 2014. The number of cases increased steadily across cohorts over time since 1995. Pediatric patients tended to be diagnosed in adolescence (mean age: 13.4 years, range: 3.0-18.0 years). Most patients received surgical management as a part of their case (95.3% of total cohort). The 5-year disease-specific survival was > 90% for each cohort. CONCLUSIONS The age-adjusted incidence rate of pediatric mucoepidermoid carcinoma of the parotid gland remains low and is not greatly changing. This cancer is most likely diagnosed in adolescence affecting both male and female patients equally. Analysis of cases since 1973 revealed that most patients continue to receive surgical care. Survival for these pediatric patients continues to remain excellent. Healthcare providers should note these updates in pediatric mucoepidermoid carcinoma of the parotid gland as effective diagnosis and management continues to lead to good survival outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 128:2408-2414, 2018.
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Affiliation(s)
- Tyler A Janz
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - P Ryan Camilon
- Department of Otolaryngology-Head and Neck Surgery, Boston University, Boston, Massachusetts, U.S.A
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jessica R Levi
- Department of Otolaryngology-Head and Neck Surgery, Boston University, Boston, Massachusetts, U.S.A
| | - Eric J Lentsch
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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15
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Vargas Gamarra MF, Perolada Vilmaña JM, Armengot Carceller M. Low grade mucoepidermoid carcinoma of a minor salivary gland of the tongue in a paediatric patient. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:367-369. [PMID: 29106823 DOI: 10.1016/j.otorri.2017.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 11/28/2022]
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16
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Levi S, Zini A, Fischman S, Czerninski R. Epidemiology of oral, salivary gland and pharyngeal cancer in children and adolescents between 1970 and 2011. Oral Oncol 2017; 67:89-94. [DOI: 10.1016/j.oraloncology.2017.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/01/2017] [Accepted: 02/11/2017] [Indexed: 11/28/2022]
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17
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Fresneau B, Dourthe ME, Jouin A, Laurence V, de Lambert G, Colas C, Coret M, Laprie A, Rebours C, Orbach D, Demoor-Goldschmidt C. Carcinomes des adolescents et jeunes adultes : quelles spécificités ? Bull Cancer 2017; 104:267-280. [DOI: 10.1016/j.bulcan.2016.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 01/23/2023]
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18
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Lewis AG, Tong T, Maghami E. Diagnosis and Management of Malignant Salivary Gland Tumors of the Parotid Gland. Otolaryngol Clin North Am 2017; 49:343-80. [PMID: 27040585 DOI: 10.1016/j.otc.2015.11.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Malignant parotid tumors are heterogeneous and diverse. Accurate diagnosis requires a pathologist familiar with the various histologic subtypes, immunohistochemistry stains, and common translocations. Clinical course varies according to tumor subtype, ranging from indolent, slow-growing adenoid cystic carcinoma to rapidly progressive, possibly fatal, salivary ductal carcinoma. Histologic grade is important in prognosis and therapy. Surgery remains the mainstay of treatment when negative margins can be achieved. Radiation improves locoregional control of tumors with high-risk features. Chemotherapy for parotid tumors can be disappointing. Studies of new targeted therapies have not offered significant benefits.
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Affiliation(s)
- Aaron G Lewis
- Department of Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Tommy Tong
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Ellie Maghami
- Division of Head and Neck Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
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19
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Cutaneous Metastasis of a Mucoepidermoid Carcinoma of the Pancreas: First Reported Case. Am J Dermatopathol 2017; 38:852-856. [PMID: 27043340 DOI: 10.1097/dad.0000000000000604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mucoepidermoid pancreatic cancer is a rare entity with only 8 cases reported in the literature. On review of the literature, the authors found that cutaneous metastases in pancreatic cancer are rare and have not been associated with the mucoepidermoid subtype. The authors present the first reported case of cutaneous metastasis in a patient with mucoepidermoid carcinoma of the pancreas. CASE PRESENTATION A 50-year old white male with a metastatic invasive poorly differentiated mucoepidermoid carcinoma of the pancreas was found to have a slow growing lesion in the skin over his left upper quadrant while undergoing active therapy. The lesion was biopsied and the pathology was consistent with pancreatic origin sharing similar morphologic features when compared with the primary pancreactectomy specimen. CONCLUSIONS Mucoepidermoid pancreatic cancer is an exceedingly rare subtype of pancreatic cancer, with very little information regarding its diagnosis, treatment, and patterns of metastases. Here, the authors present the first reported case of cutaneous metastases of mucoepidermoid pancreatic cancer.
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20
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Martínez OM, Dorado ED, García MDA, Ramírez MIO, de la Fuente Muñoz I, Soler JLF. Locally Advanced Stage High-Grade Mucoepidermoid Carcinoma of Salivary Gland in a 9-Year-Old Girl: The Controversy of Adjuvant Therapy. Rare Tumors 2016; 8:6429. [PMID: 27746885 PMCID: PMC5064301 DOI: 10.4081/rt.2016.6429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 04/08/2016] [Accepted: 04/12/2016] [Indexed: 11/23/2022] Open
Abstract
Malignant salivary gland tumors are rare in children, mostly represented by low-grade mucoepidermoid carcinomas. For these patients, long-term survival rates above 95% are reported after surgical resection. Here we report a case of a 9-year-old girl with a high grade locally advanced mucoepidermoid carcinoma undergoing adjuvant radiotherapy and chemotherapy after surgery. We emphasize the controversy and lack of evidence-based indication for these highly toxic adjuvant therapy modalities in children.
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Affiliation(s)
- Olga Micol Martínez
- Department of Oncology and Pediatric Hematology, University Hospital Virgen de la Arrixaca , Murcia, Spain
| | - Elena Daghoum Dorado
- Department of Oncology and Pediatric Hematology, University Hospital Virgen de la Arrixaca , Murcia, Spain
| | | | | | | | - Jose Luis Fuster Soler
- Department of Oncology and Pediatric Hematology, University Hospital Virgen de la Arrixaca , Murcia, Spain
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21
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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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22
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Techavichit P, Hicks MJ, López-Terrada DH, Quintanilla NM, Guillerman RP, Sarabia SF, Sayeed H, Nuchtern JG, Paulino AC, Muscal JA, Okcu MF, Chintagumpala M. Mucoepidermoid Carcinoma in Children: A Single Institutional Experience. Pediatr Blood Cancer 2016. [PMID: 26221861 DOI: 10.1002/pbc.25681] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE AND OBJECTIVE To determine the clinicopathologic and molecular features and outcome of children with mucoepidermoid carcinoma (MEC). METHODS A retrospective analysis of clinical and histopathologic findings was performed in patients with MEC diagnosed at Texas Children's Cancer Center between 2000 and 2014. RESULTS Ten female and four male patients with median age 12 years (range 7-19 years) were included in the study. Tumors involved major salivary glands, minor salivary glands of the palate, and the tracheobronchial tree. Nine of 11 patients with salivary MEC underwent more than one surgical resection at the time of initial diagnosis to achieve a gross total resection. Three patients with tracheobronchial tumors underwent pulmonary lobectomy. Three patients received postoperative radiation therapy. No patient was treated with chemotherapy. Histopathologic grades were classified as low (n = 2), intermediate (n = 9), and high (n = 3). All 12 patients with tumor tissue available for testing were positive for MECT1/MAML2 fusion transcripts. There were no deaths, metastases, or recurrences in this series, with a median follow-up of 24 months (range 5-96 months). CONCLUSIONS Low to intermediate histopathologic grade MECs are more common than high grade MEC in children. In contrast to adults, MECT1/MAML2 fusion transcripts occur with a frequency of 100% in our pediatric MEC series. Complete excision is the treatment of choice and is associated with excellent outcome. The role of radiotherapy is unclear, but may be indicated in patients with high grade tumors with positive surgical margins.
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Affiliation(s)
- Piti Techavichit
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Division of Hematology and Oncology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M John Hicks
- Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Dolores H López-Terrada
- Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Norma M Quintanilla
- Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - R Paul Guillerman
- Department of Pediatric Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Stephen F Sarabia
- Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Hadi Sayeed
- Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Jed G Nuchtern
- Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Arnold C Paulino
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jodi A Muscal
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - M Fatih Okcu
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Murali Chintagumpala
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
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23
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Grant SR, Grosshans DR, Bilton SD, Garcia JA, Amin M, Chambers MS, McGovern SL, McAleer MF, Morrison WH, Huh WW, Kupferman ME, Mahajan A. Proton versus conventional radiotherapy for pediatric salivary gland tumors: Acute toxicity and dosimetric characteristics. Radiother Oncol 2015; 116:309-15. [PMID: 26232128 DOI: 10.1016/j.radonc.2015.07.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/12/2015] [Accepted: 07/18/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE We evaluated acute toxicity profiles and dosimetric data for children with salivary gland tumors treated with adjuvant photon/electron-based radiation therapy (X/E RT) or proton therapy (PRT). METHODS AND MATERIALS We identified 24 patients who had received adjuvant radiotherapy for salivary gland tumors. Data were extracted from the medical records and the treatment planning systems. Toxicity was scored according to the Common Terminology Criteria for Adverse Effects 4.0. RESULTS Eleven patients received X/E RT and 13 PRT, with a median prescribed dose of 60 Gy in each group. In the X/E RT group, 54% of patients developed acute grade II/III dermatitis, 27% grade II/III dysphagia, and 91% grade II/III mucositis, and the median weight loss was 5.3% with one patient requiring feeding tube placement. In the PRT group, 53% had acute grade II/III dermatitis, 0% grade II/III dysphagia, and 46% grade II/III mucositis, with a median weight gain of 1.2%. Additionally, PRT was associated with lower mean doses to several normal surrounding midline and contralateral structures. CONCLUSION In this retrospective study of pediatric salivary tumors, PRT was associated with a favorable acute toxicity and dosimetric profile. Continued follow-up is needed to identify long-term toxicity and survival data.
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Affiliation(s)
| | - David R Grosshans
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Stephen D Bilton
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - John A Garcia
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Mayank Amin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Mark S Chambers
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Susan L McGovern
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Mary F McAleer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - William H Morrison
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Winston W Huh
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Michael E Kupferman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Anita Mahajan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
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24
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Qureshi SS, Bhagat M, Singhal N, Tathe N, Kembhavi S, Laskar S, Ramadwar M, Yadav P. Clinical characteristics and treatment outcomes of primary and recurrent malignancy involving the salivary glands in children. Head Neck 2015; 38:852-6. [DOI: 10.1002/hed.24114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 02/05/2023] Open
Affiliation(s)
- Sajid S. Qureshi
- Department of Surgical Oncology, Division of Pediatric Surgical Oncology; Tata Memorial Centre; Bombay India
| | - Monica Bhagat
- Department of Surgical Oncology, Division of Pediatric Surgical Oncology; Tata Memorial Centre; Bombay India
| | - Nitin Singhal
- Department of Surgical Oncology, Division of Pediatric Surgical Oncology; Tata Memorial Centre; Bombay India
| | - Nitin Tathe
- Department of Surgical Oncology, Division of Pediatric Surgical Oncology; Tata Memorial Centre; Bombay India
| | - Seema Kembhavi
- Department of Radiology; Tata Memorial Centre; Bombay India
| | - Siddharth Laskar
- Department of Radiation Oncology; Tata Memorial Centre; Bombay India
| | - Mukta Ramadwar
- Department of Pathology; Tata Memorial Centre; Bombay India
| | - Prabha Yadav
- Department of Plastic and Reconstructive Surgery; Tata Memorial Centre; Bombay India
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25
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Chiaravalli S, Guzzo M, Bisogno G, De Pasquale MD, Migliorati R, De Leonardis F, Collini P, Casanova M, Cecchetto G, Ferrari A. Salivary gland carcinomas in children and adolescents: the Italian TREP project experience. Pediatr Blood Cancer 2014; 61:1961-8. [PMID: 25132368 DOI: 10.1002/pbc.25139] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 05/16/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Salivary gland carcinomas are extremely rare in pediatric age. We report the clinical features of a series of children/adolescents with salivary gland carcinomas prospectively registered in the Italian TREP (Rare Tumors in Pediatric Age) project. PROCEDURES Diagnostic/therapeutic guidelines were developed and shared among Italian pediatric oncology/surgical centers. RESULTS Seventeen patients were registered between 2000 and 2012, representing 19% of the cases expected to be seen based on epidemiological data. Tumors arose mainly in the parotid gland (14 cases). In most cases they were low-grade tumors (14 cases), often with a favorable clinical presentation, and low-stage disease. All patients underwent surgical resection, achieving histologically free margins in 9/17 cases. Thirteen of the 14 patients with parotid gland tumors had parotidectomy (10 total, 3 superficial), while one had a tumorectomy. Postoperative facial nerve lesions were reported in two cases. Adjuvant radiotherapy was given to 6 patients. The overall prognosis was good: only one patient with a huge high-grade tumor experienced disease progression and died of the disease. The other 16 patients were alive in first continuous remission 1-8 years after diagnosis. In 4/17 cases, the salivary gland carcinoma was a second tumor occurring 6-9 years after another primary cancer. CONCLUSIONS This is the first reported prospective national cooperative series of pediatric salivary gland carcinoma patients. Compliance with the TREP recommendations was high. These tumors are rarely managed by pediatric oncologists/surgeons. A broader international cooperation and better networking with otolaryngologists and head-neck surgeons expert on adult salivary gland carcinomas would be advisable.
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Affiliation(s)
- Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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26
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Sepúlveda I, Frelinghuysen M, Platin E, Spencer ML, Compan A, Munzenmayer J, Ulloa D. Mandibular central mucoepidermoid carcinoma: a case report and review of the literature. Case Rep Oncol 2014; 7:732-8. [PMID: 25493087 PMCID: PMC4256002 DOI: 10.1159/000368825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report the case of a patient whose main complaint was swelling on the right side of the mandible when he presented to the Ear, Nose and Throat (ENT) Service. Imaging studies revealed a large homogeneous, multilocular, expansive lesion in the body of the right mandibular ramus. The lesion was poorly enhanced following intravenous contrast injection. The patient was treated with hemimandibular surgical resection, fibula free flap reconstruction and adjuvant radiotherapy. Currently, the patient is disease free and free of posttreatment complications.
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Affiliation(s)
- Ilson Sepúlveda
- ENT-Head and Neck Surgery Service, General Hospital of Concepción, Santiago, Chile ; Finis Terrae University, School of Dentistry, Santiago, Chile
| | - Michael Frelinghuysen
- Radiotherapy Unit of Oncology Service, General Hospital of Concepción, Santiago, Chile
| | - Enrique Platin
- Department of Oral and Maxillofacial Radiology, University of North Carolina School of Dentistry, Chapel Hill, N.C., USA
| | - M Loreto Spencer
- Pathology Department, General Hospital of Concepción, Santiago, Chile
| | - Alvaro Compan
- ENT-Head and Neck Surgery Service, General Hospital of Concepción, Santiago, Chile
| | | | - David Ulloa
- Private Practice, Concepción, School of Dentistry, Santiago, Chile
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27
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Biron VL, Lentsch EJ, Gerry DR, Bewley AF. Factors influencing survival in acinic cell carcinoma: a retrospective survival analysis of 2061 patients. Head Neck 2014; 37:870-7. [PMID: 24623677 DOI: 10.1002/hed.23686] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/13/2014] [Accepted: 03/07/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Acinic cell carcinoma is an uncommon salivary neoplasm with clinical and histologic features known to influence prognosis. The purpose of this study was to further describe variables influencing survival in a large cohort of patients with acinic cell carcinoma. METHODS Using the Surveillance, Epidemiology, and End Results (SEER) registry, we obtained demographic, clinicopathologic, and treatment data pertaining to patients diagnosed with acinic cell carcinoma. Kaplan-Meier and Cox regression analyses were performed to compare survival with various clinical and pathological parameters. RESULTS We identified 2061 patients with acinic cell carcinoma from 1973 to 2009. Sex, staging, grade, subsite, and treatment were significant predictors of disease-specific survival (DSS). Patients who received surgery alone had the highest 20-year DSS (92.4%), followed by those treated with surgery and radiation (71.9%) or radiation alone (62.3%). CONCLUSION Our results suggest that histologic grade is a stronger predictor of survival than TNM classification, survival after surgical resection alone is excellent, and adjuvant radiation may be of limited benefit
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Affiliation(s)
- Vincent L Biron
- Department of Otolaryngology, University of California Davis, Sacramento, California
| | - Eric J Lentsch
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Daniel R Gerry
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.,Mercer University School of Medicine, Savannah, Georgia
| | - Arnaud F Bewley
- Department of Otolaryngology, University of California Davis, Sacramento, California
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Management of salivary gland malignancies in the pediatric population. Curr Opin Otolaryngol Head Neck Surg 2014; 22:116-20. [DOI: 10.1097/moo.0000000000000026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Kose M, Bilgin M, Kontas O, Ozturk S, Doganay S, Ozdemir MA. A case of mucoepidermoid carcinoma of the bronchus presented with hydropneumothorax in a child. Pediatr Pulmonol 2014; 49:E86-9. [PMID: 24167037 DOI: 10.1002/ppul.22938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/17/2013] [Indexed: 11/11/2022]
Abstract
Mucoepidermoid carcinoma is a rare pulmonary neoplasm seen in the pediatric population. We report a low grade mucoepidermoid carcinoma in a 12-year-old boy who presented with spontaneous pneumothorax.
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Affiliation(s)
- Mehmet Kose
- Department of Pediatrics, Division of Pediatric Pulmonology Unit, Erciyes University, Kayseri, Turkey
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