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

  • 발행 : 2014.10.23

초록

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.

참고문헌

  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

피인용 문헌

  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