DOI QR코드

DOI QR Code

Outcome of Surgery and Post-Operative Radiotherapy for Major Salivary Gland Carcinoma: Ten Year Experience from a Single Institute

  • Kaur, Jaspreet (All India Institute of Medical Sciences) ;
  • Goyal, Shikha (All India Institute of Medical Sciences) ;
  • Muzumder, Sandeep (All India Institute of Medical Sciences) ;
  • Bhasker, Suman (All India Institute of Medical Sciences) ;
  • Mohanti, Bidhu Kalyan (Fortis Memorial Research Institute) ;
  • Rath, Goura Kishore (All India Institute of Medical Sciences)
  • Published : 2014.10.23

Abstract

Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT). Materials and Methods: We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method. Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months. Conclusions: Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.

Keywords

Major salivary gland;carcinoma;radiotherapy;surgery;outcome

References

  1. Bell RB, Dierks EJ, Homer L, Potter BE (2005). Management and outcome of patients with malignant salivary gland tumors. J Oral Maxillofac Surg, 63, 917-28. https://doi.org/10.1016/j.joms.2005.03.006
  2. Jaafari-Ashkavandi Z, Ashraf MJ, Moshaverinia M (2013). Salivary gland tumors: a clinicopathologic study of 366 cases in southern Iran. Asian Pac J Cancer Prev, 14, 27-30. https://doi.org/10.7314/APJCP.2013.14.1.27
  3. Chen AM, Granchi PJ, Garcia J, et al (2007). Local-regional recurrence after surgery without postoperative irradiation for carcinomas of the major salivary glands: implications for adjuvant therapy. Int J Radiat Oncol Biol Phys, 67, 982-7. https://doi.org/10.1016/j.ijrobp.2006.10.043
  4. Garden AS, El-Naggar AK, Morrison WH, et al (1997). Postoperative radiotherapy for malignant tumors of the parotid gland. Int J Rad Oncol Biol Phys, 37, 79-85. https://doi.org/10.1016/S0360-3016(96)00464-6
  5. Iqbal H, Bhatti AB, Hussain R, Jamshed A (2014). Ten year experience with surgery and radiation in the management of malignant major salivary gland tumors. Asian Pac J Cancer Prev, 15, 2195-9. https://doi.org/10.7314/APJCP.2014.15.5.2195
  6. Jones AV, Craig GT, Speight PM, Franklin CD (2008). The range and demographics of salivary gland tumors diagnosed in a UK population. Oral Oncol, 44, 407-17. https://doi.org/10.1016/j.oraloncology.2007.05.010
  7. Mejia-Velazquez CP, Duran-Padilla MA, Gomez-Apo E, Quezada-Rivera D, Gaitan-Cepeda LA (2012). Tumors of the salivary gland in Mexicans. A retrospective study of 360 cases. Med Oral Pathol Oral Cir Bucal, 17, 183-9.
  8. Moriniere S, Perie S, Lacau St Guily J (2007). Primary and non-primary parotid malignancies: comparison of treatment modalities and outcomes. Eur Arch Otorhinolaryngol, 264, 231-7. https://doi.org/10.1007/s00405-006-0172-1
  9. Pinkston JA, Cole P (1999). Incidence rates of salivary gland tumors: results from a population-based study. Otolaryngol Head Neck Surg, 120, 834-40. https://doi.org/10.1016/S0194-5998(99)70323-2
  10. Pohar S, Gay H, Rosenbaum P, et al (2005). Malignant parotid tumors: presentation, clinical/pathologic prognostic factors, and treatment outcomes. Int J Rad Oncol Biol Phys, 61,112-8. https://doi.org/10.1016/j.ijrobp.2004.04.052
  11. Theresa AG, David WE, Vivian W (2005). Adenoid cystic carcinoma of the major salivary glands treated with surgery and radiation. The Laryngoscope, 115, 1278-82. https://doi.org/10.1097/01.MLG.0000165381.64157.AD
  12. Shang J, Wu Y, Wang W, Wang K, Ge M (2012). Analysis of prognostic risk factors and treatment of parotid cancer. Oncol Lett, 3, 1307-10.
  13. Stelzer KJ, Laramore GE, Griffin TW (1994). Fast neutron radiotherapy. the university of washington experience. Acta Oncol, 33, 275-280. https://doi.org/10.3109/02841869409098417
  14. Teo PM, Chan AT, Lee WY, et al (2000). Failure patterns and factors affecting prognosis of salivary gland carcinoma: retrospective study. Hong Kong Med J, 6, 29-36.
  15. To VS, Chan JY, Tsang RK, Wei WI (2012). Review of salivary gland neoplasms. ISRN Otolaryngol.
  16. Toonkel LM, Guha S, Foster P, Dembrow V (1994). Radiotherapy for parotid cancer. Ann Surg Oncol, 1,468-72. https://doi.org/10.1007/BF02303611
  17. Vinod Raina, Tyagi BB, Manoharan N (2003). Population based cancer registry, Delhi. Individual Registry Data, 2001-2003, 154-73.
  18. Wahlberg P, Anderson H, Biorklund A, Moller T, Perfekt R (2002). Carcinoma of the parotid and submandibular glands a study of survival in 2465 patients. Oral Oncol, 38, 706-13. https://doi.org/10.1016/S1368-8375(02)00007-6

Cited by

  1. Parotid Gland Tumours in Turkish Population: Analysis of 165 Patients vol.16, pp.8, 2015, https://doi.org/10.7314/APJCP.2015.16.8.3539
  2. Prognostic Factors and Clinical Outcome in Parotid Gland Tumors: a Single Institution Experience from the Eastern Black Sea Region of Turkey vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1169
  3. Postoperative radiotherapy for mucoepidermoid carcinoma of the major salivary glands: long-term results of a single-institution experience vol.36, pp.4, 2018, https://doi.org/10.3857/roj.2018.00409