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A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from T he N etherlands
Author(s) -
Boon Eline,
Bel Miranda,
van Boxtel Wim,
van der Graaf Winette T. A.,
van Es Robert J. J.,
Eerenstein Simone E. J.,
Baatenburg de Jong Robert J.,
van den Brekel Michiel W. M.,
van der Velden LillyAnn,
Witjes Max J. H.,
Hoeben Ann,
Willems Stefan M.,
Bloemena Elisabeth,
Smit Laura A.,
Oosting Sjoukje F.,
Jonker Marianne A.,
Flucke Uta E.,
van Herpen Carla M. L.
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31353
Subject(s) - medicine , salivary duct carcinoma , lymph node , oncology , immunohistochemistry , salivary gland cancer , pathology , cohort , cancer
Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo‐ and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease‐free survival (DFS), distant metastasis‐free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in‐situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and—to a lesser extent—HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting.