Premium
Predictors of outcomes in large cell undifferentiated carcinoma of the major salivary glands
Author(s) -
Schrank Travis P.,
Zhan Kevin Y.,
Lentsch Eric J.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26136
Subject(s) - medicine , occult , salivary gland cancer , incidence (geometry) , stage (stratigraphy) , cancer , retrospective cohort study , carcinoma , radiation therapy , disease , cancer registry , metastasis , salivary gland , oncology , neck dissection , pathology , paleontology , physics , alternative medicine , optics , biology
Objective Major salivary gland large‐cell undifferentiated carcinoma (LCUC) is rare and has a poor prognosis. Characterization of patient demographics, tumor characteristics, and predictors of outcome have been limited by low case numbers, as well as grouped analysis with other salivary malignancies. The objective of this study was to address these issues using large‐scale national data. Study Design Retrospective case series. Methods Data from the National Cancer Database, including cases diagnosed from 1998 to 2012, was analyzed, identifying 247 records of LCUC. Tumor, demographic, and survival information was extracted and analyzed retrospectively. Results Large‐cell undifferentiated carcinoma comprised < 1% of all major salivary gland cancers. Seventy percent of patients presented with advanced‐stage disease. The incidence of occult nodal disease was 39%. Surgery followed by radiation was the most common treatment. Five‐year overall survival was 36%. Comorbidity, distant metastasis, and positive surgical margins were found to be predictors of overall survival. Conclusion To our knowledge, this represents the largest reported case series of LCUC. The survival analysis demonstrates poorer survival in patients with positive surgical margins; therefore, efforts to complete resection are reasonable. Reported high rates of occult nodal disease also strongly support elective treatment of the neck. Level of Evidence 4. Laryngoscope , 2016 127:372–376, 2017