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Hofmann E, Priebe J, Rieke DT, Doll C, Coordes A, Olze H, Hofmann VM, Heiland M, Beck-Broichsitter B. Prognostic factors in surgically treated malignant salivary gland tumors. Oral Oncol 2023; 144:106484. [PMID: 37421674 DOI: 10.1016/j.oraloncology.2023.106484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES To identify prognostic factors for evidence-based risk stratification in malignant salivary gland tumors. METHODS This retrospective study identified 162 patients who presented with malignant salivary gland tumors between 2010 and 2020. Final analysis included 91 patients who underwent surgical treatment at our institution and were followed-up for ≥ 1 year. Medical records were reviewed and patients were categorized according to their risk profile. RESULTS This study included 91 patients (51 males, 40 females, mean age 61 years). The most frequent entities were adenoid cystic carcinoma (n = 13, 14.3%) and mucoepidermoid carcinoma (n = 12, 13.2%). Kaplan-Meier analysis demonstrated a five-year overall survival (OS) of 66.2% and a recurrence-free survival (RFS) of 50.5%. Age > 60 years (p = 0.011), categorization into high-risk group (p = 0.011), UICC stage (p = 0.020), T stage (p = 0.032), grading (p = 0.045) and vascular invasion (p < 0.001) were significantly associated with OS; age > 60 years (p = 0.014), categorization into high-risk group (p < 0.001), UICC stage (p = 0.021), T stage (p = 0.017), grading (p = 0.011), vascular invasion (p = 0.012) and lymphovascular invasion (p < 0.001) were significantly associated with RFS. Multivariate Cox regression with backward elimination identified T stage (HR 1.835; 95% CI 1.187-2.836; p = 0.006) and grading (HR 2.233; 95% CI 1.113-4.480; p = 0.024) as significant factors for OS. Grading (HR 2.499; 95% CI 1.344-4.648; p = 0.004) was confirmed as a significant factor for RFS. CONCLUSION Considering the risk of recurrence and distant metastasis in malignant salivary gland tumors, locoregional surgical control may not be sufficient and adjuvant therapies such as radiotherapy and/or systemic therapies should be considered.
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Affiliation(s)
- Elena Hofmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Junior Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany.
| | - Janine Priebe
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Damian Tobias Rieke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Comprehensive Cancer Center, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Doll
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Annekatrin Coordes
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Campus Virchow Klinikum/ Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; University Medical Centre Ruppin Brandenburg, Brandenburg Medical School, Department of Otorhinolaryngology, Head and Neck Surgery, Fehrbelliner Straße 38, 16816 Neuruppin, Germany; Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Joint Faculty of the University of Potsdam, Faculty of Health Sciences Brandenburg, Am Neuen Palais 10, House 9, 14469 Potsdam, Germany
| | - Heidi Olze
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Campus Virchow Klinikum/ Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany
| | - Veit M Hofmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany
| | - Max Heiland
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Benedicta Beck-Broichsitter
- Katharinenhospital Klinikum Stuttgart, Department of Oral and Maxillofacial Surgery, Kriegsbergstraße 60, 70174 Stuttgart, Germany
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The Combination of Inflammatory Biomarkers as Prognostic Indicator in Salivary Gland Malignancy. Cancers (Basel) 2022; 14:cancers14235934. [PMID: 36497416 PMCID: PMC9740974 DOI: 10.3390/cancers14235934] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background: The aim of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, are associated with overall survival (OS) in patients surgically treated for malignant salivary gland tumors (MSGTs). Methods: A retrospective analysis of 74 cases following surgery at our department between January 2011 and June 2018 was performed. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Survival curves of different groups at 1−3−5 years were estimated using the Kaplan−Meier method. Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The ROC curves revealed that the best combination with AUC = 0.884 was SII + SIRI. The estimated 5-year OS probability in patients with SII+ SIRI scores of 0, 1, and 2 was 96%, 87.5% and 12.5%, respectively (p < 0.001). Conclusion: SII+ SIRI can independently predict the OS of patients after MSGT surgery. The prognostic score system based on SII+ SIRI may be good clinical practice as a reference for clinical decision-making.
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Non-primary salivary malignancies: A 22-year retrospective study. J Craniomaxillofac Surg 2019; 47:1351-1355. [PMID: 31331848 DOI: 10.1016/j.jcms.2019.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/14/2019] [Accepted: 06/27/2019] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Most salivary gland malignancies are primary tumors, but in our medical center one of six is non-primary. The relative scarcity of such reports justifies studying them. SUBJECTS & METHODS We studied patients' demographic and clinical parameters, salivary tumors/metastasis, diagnosis and treatment, and survival rates. RESULTS Of all our salivary malignancy patients over the last 22 years, 15% (18/119) had non-primary malignant tumors, all located in the parotid glands. Of these, nine had skin cancer (SCC), 3 malignant solid tumors and 6 hematological systemic malignancies. Four had concomitant second malignancy. Mean age was 70.2 ± 13.8 years, 66.7% of the patients were males, 27.8% were smokers, none reported alcohol use. The most prevalent diagnostic tools used were CT (16 patients), FNA (13) and PET-CT (12). Eleven of 18 patients died from the disease despite receiving therapy: 6 SCC patients, 2 CLL patients and all 3 with solid tumors. All four lymphoma patients survived as did another three SCC patients. CONCLUSIONS Chemotherapy and radiotherapy for systemic disease prolonged life rather than surgery. Patients with poor prognosis non-primary salivary tumors should be treated conservatively; surgery should be for those without widespread metastases or systemic disease. Sometimes a palliative patient may benefit from tumor debulking.
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