Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Ten Year Experience with Surgery and Radiation in the Management of Malignant Major Salivary Gland Tumors

  • Iqbal, Hassan (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Bhatti, Abu Bakar Hafeez (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Hussain, Raza (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Jamshed, Arif (Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
  • Published : 2014.03.01
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Abstract

Background: Despite being rare in incidence, malignant tumors of major salivary glands show diverse histological variation. There are limited data on major salivary gland tumor management and outcome from Pakistan. The objective of this study was to share our experience with management of malignant tumors of major salivary glands. Materials and Methods: Patients who received treatment at Shaukat Khanum Cancer Hospital and Research Center from July 2002 to June 2011 with an underlying diagnosis of a major salivary gland malignancy were included. Patient characteristics and treatment modalities were assessed. Local, regional and distant failures were determined. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan Meier curves and the Log rank test was used to determine statistical significance. Univariate and multivariate analyses were performed using Cox proportional hazard regression. Results: The parotid gland was the primary site of origin in 104 (80%) patients. Mucoepidermoid carcinoma (43%) and adenoid cystic carcinoma (24%) were the most common histological types. Surgery followed by adjuvant radiation remained the mainstay treatment modality with 81 (62%) patients. Nineteen (15%) patients were treated with surgery alone and 30 (23%) patients with locally advanced surgically inoperable tumors received radiation only. Forty one (32%) patients failed the treatment (local 12, regional 11, locoregional 5, distant 13). The expected 5 year DFS and OS were 65% and 74% respectively. On multivariate analysis, grade was the only independent predictor of DFS and nodal involvement was the only independent predictor of overall survival. Conclusions: Employing existing standards of treatment, comparable survival can be achieved in Pakistani population with major salivary gland malignancies as elsehwere in the world.

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References

  1. Ali S, Sarhan M, Palmer FL, et al (2013). Cause-specific mortality in patients with mucoepidermoid carcinoma of the major salivary glands. Ann Surg Oncol, 20, 2396-404. https://doi.org/10.1245/s10434-013-2872-2
  2. Armstrong JG, Harrison LB, Spiro RH, et al (1990). Malignant tumors of major salivary gland origin. A matched-pair analysis of the role of combine surgery and postoperative radiotherapy. Arch Otolaryngol Head Neck Surg, 116, 290-3. https://doi.org/10.1001/archotol.1990.01870030054008
  3. Armstrong JG, Harrison LB, Thaler HT, et al (1992). The indications for elective treatment of the neck in cancer of the major salivary glands. Cancer, 69, 615-9. https://doi.org/10.1002/1097-0142(19920201)69:3<615::AID-CNCR2820690303>3.0.CO;2-9
  4. Bhide SA, Miah A, Barbachano Y, et al (2009). Harrington KJ, Newbold K, Nutting CM. Radical radiotherapy for treatment of malignant parotid tumours: a single centre experience 1995-2005. Br J Oral Maxillofac Surg, 47, 284-9. https://doi.org/10.1016/j.bjoms.2008.12.012
  5. Brennan PA, Davies B, Poller D, et al (2010). Fine needle aspiration cytology (FNAC) of salivary gland tumours: repeat aspiration provides further information in cases with an unclear initial cytological diagnosis. Br J Oral Maxillofac Surg, 48, 26-9. https://doi.org/10.1016/j.bjoms.2008.12.014
  6. Burke CJ, Thomas RH, Howlett D (2011). Imaging the major salivary glands. Br J Oral Maxillofac Surg, 49, 261-9. https://doi.org/10.1016/j.bjoms.2010.03.002
  7. Etit D, Ekinci N, Tan A, Altinel D, Dag F (2012). An analysis of salivary gland neoplasms: a 12-year, single-institution experience in Turkey. Ear Nose Throat J, 91, 125-9.
  8. Fitzpatrick PJ, Theriault C (1986). Malignant salivary gland tumors. Int J Radiat Oncol Biol Phys, 12, 1743-7. https://doi.org/10.1016/0360-3016(86)90314-7
  9. Garden AS, el-Naggar AK, Morrison WH, et al (1997). Postoperative radiotherapy for malignant tumors of the parotid gland. Int J Radiat Oncol Biol Phys, 37, 79-85. https://doi.org/10.1016/S0360-3016(96)00464-6
  10. Hocwald E, Korkmaz H, Yoo GH, et al (2001). Prognostic factors in major salivary gland cancer. Laryngoscope, 111, 1434-9. https://doi.org/10.1097/00005537-200108000-00021
  11. 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
  12. Jaafari-Ashkavandi Z, Najvani AD, Tadbir AA, et al (2013). MCM3 as a novel diagnostic marker in benign and malignant salivary gland tumors. Asian Pac J Cancer Prev, 14, 3479-82. https://doi.org/10.7314/APJCP.2013.14.6.3479
  13. Koul R, Dubey A, Butler J, et al (2007). Prognostic factors depicting disease-specific survival in parotid-gland tumors. Int J Radiat Oncol Biol Phys, 68, 714-8. https://doi.org/10.1016/j.ijrobp.2007.01.009
  14. Lima RA, Tavares MR, Dias FL, et al (2005). Clinical prognostic factors in malignant parotid gland tumors. Otolaryngol Head Neck Surg, 133, 702-8. https://doi.org/10.1016/j.otohns.2005.08.001
  15. Luksic I, Virag M, Manojlovic S, Macan D (2012). Salivary gland tumours: 25 years of experience from a single institution in Croatia. J Craniomaxillofac Surg, 40, 75-81. https://doi.org/10.1016/j.jcms.2011.05.002
  16. Matsuba HM, Thawley SE, Devineni VR, Levine LA, Smith PG (1985). High-grade malignancies of the parotid gland: effective use of planned combined surgery and irradiation. Laryngoscope, 95, 1059-63.
  17. Malik KA (2007). Parotid gland tumors: A six years experience. Pak J Surg, 23, 133-135.
  18. Musani MA, Sohail Z, Zafar S, Malik S (2008). Morphological pattern of parotid gland tumours. J Coll Physicians Surg Pak, 18, 274-7.
  19. North CA, Lee D, Piantadosi S, et al (1990). Carcinoma of the major salivary glands treated by surgery or surgery plus postoperative radiotherapy. Int J Radiat Oncol Biol Phys, 18, 1319-26. https://doi.org/10.1016/0360-3016(90)90304-3
  20. 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
  21. Spiro RH, Huvos AG, Strong EW (1975). Cancer of the parotid gland, A clinico-pathology study of 288 primary cases. Am J Surg, 130, 452-9. https://doi.org/10.1016/0002-9610(75)90483-3
  22. Spiro RH (1986). Salivary neoplasms: overview of a 35-year experience with 2807 patients. Head Neck Surg, 8, 177-84. https://doi.org/10.1002/hed.2890080309
  23. Spiro RH, Dubner S (1990). Salivary gland tumors. Curr Opin Oncol, 2, 589-95. https://doi.org/10.1097/00001622-199006000-00025
  24. Schlakman BN, Yousem DM (1993). MR of intraparotid masses. AJNR Am J Neuroradiol, 14, 1173-80.
  25. Shah SA, Riaz U, Zubair M, Saaiq M (2013). Surgical presentation and outcome of parotid gland tumours. J Coll Physicians Surg Pak, 23, 625-8.
  26. Shishegar M, Ashraf MJ, Azarpira N, et al (2011). Salivary gland tumors in maxillofacial region: a retrospective study of 130 cases in a southern Iranian population. Patholog Res Int, 2011, 934350.
  27. Terhaard CH, Lubsen H, Rasch CR, et al (2004). Dutch Head and Neck Oncology Cooperative Group (2004). Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck, 26, 681-92. https://doi.org/10.1002/hed.10400
  28. Terhaard CH, Lubsen H, Rasch CR, et al (2005). Dutch Head and Neck Oncology Cooperative Group (2005). The role of radiotherapy in the treatment of malignant salivary gland tumors. Int J Radiat Oncol Biol Phys, 61, 103-11. https://doi.org/10.1016/j.ijrobp.2004.03.018
  29. Vander Poorten VLM, Balm AJM, Hilgers FJM, et al (1999). Prognostic factors for long term results of the treatment of patients with malignant submandibular gland tumors. Cancer, 85, 2255-64. https://doi.org/10.1002/(SICI)1097-0142(19990515)85:10<2255::AID-CNCR22>3.0.CO;2-D
  30. Vikram B, Strong EW, Shah JP, Spiro RH (1984). Radiation therapy in adenoid-cystic carcinoma. Int J Radiat Oncol Biol Phys, 10, 221-3. https://doi.org/10.1016/0360-3016(84)90007-5

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