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Incompletely treated malignancies of the major salivary gland: Toward evidence‐based care
Author(s) -
Tam Samantha,
Sandulache Vlad C.,
Metwalli Kareem A.,
Rock Crosby D.,
Eraj Salman A.,
Sheu Tommy,
ElNaggar Adel K.,
Fuller Clifton D.,
Weber Randal S.,
Lai Stephen Y.
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25156
Subject(s) - medicine , hazard ratio , salivary gland , proportional hazards model , malignancy , cohort , confidence interval , stage (stratigraphy) , retrospective cohort study , salivary gland cancer , disease , multivariate analysis , oncology , surgery , paleontology , biology
Background Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment‐related outcomes for patients with incompletely treated major salivary gland tumors. Methods A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure. Results Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P < .001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HR adjusted ] 2.55; 95% confidence interval [CI] 1.20‐5.30; metastatic disease HR adjusted 9.53; 95% CI 3.04‐27.06). Conclusion Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival.