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Prognostic Factors in Major Salivary Gland Cancer
Author(s) -
Hocwald Eitan,
Korkmaz Hakan,
Yoo George H.,
Adsay Volkan,
Shibuya Terry Y.,
Abrams Judith,
Jacobs John R.
Publication year - 2001
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 - 10.1097/00005537-200108000-00021
Subject(s) - perineural invasion , medicine , salivary gland cancer , oncology , radiation therapy , salivary gland , parotid gland , stage (stratigraphy) , head and neck cancer , pathological , chemotherapy , cancer , disease , lymph node , adenoid cystic carcinoma , adjuvant therapy , pathology , carcinoma , paleontology , biology
Objective To identify features of major salivary gland cancers that are prognostic for disease‐free survival. Study Design A retrospective study of 78 patients with major salivary gland cancer (64 parotid and 14 submandibular gland) who underwent surgery for definitive treatment from 1976 to 1996. A select group of patients also received adjuvant radiation (56%) and/or chemotherapy (13%). Method Clinical and pathological risk factors were obtained from patients' charts and pathology reports. Age, gender, tumor site, T‐stage, facial paralysis, histologic neck involvement, perineural invasion, and cancer grade were analyzed with respect to disease‐free survival. The role of adjuvant treatment in terms of clinical outcome was also investigated. Results In our series, the 5‐year disease‐free survival was 65%. Examining clinical and histologic features one at a time, we found poorer prognosis was associated with submandibular tumors compared with parotid ( P = .02), higher T‐stage ( P = .001), positive cervical nodes ( P <.001), perineural invasion ( P = .002), and high‐grade or adenoid cystic tumors ( P = .002). A multivariable analysis indicated that positive lymph nodes ( P = .07) and perineural invasion ( P = .03) were important histologic predictors of shorter disease‐free survival. Receipt of both adjuvant radiation and cisplatin‐based chemotherapy ( P = .05) was an independent predictor of longer disease‐free survival. Conclusion Our study indicated that the presence of positive lymph nodes and perineural invasion is important independent predictors of disease‐free survival. Our limited data also suggest that adjuvant chemotherapy and radiation therapy may improve disease‐free survival.