Prognostic factors in patients with high-risk locally advanced salivary gland cancers treated with surgery and postoperative radiotherapy

Authors

  • Trevor M. Feinstein MD,

    1. Division of Hematology–Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    2. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
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  • Stephen Y. Lai MD, PhD,

    1. Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Diana Lenzner MS,

    1. Biostatistics Facility, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
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  • William Gooding MS,

    1. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    2. Biostatistics Facility, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
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  • Robert L. Ferris MD, PhD,

    1. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    2. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Jennifer R. Grandis MD,

    1. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    2. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Eugene N. Myers MD,

    1. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    2. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Jonas T. Johnson MD,

    1. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    2. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Dwight E. Heron MD,

    1. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    2. Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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  • Athanassios Argiris MD

    Corresponding author
    1. Division of Hematology–Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    2. Head and Neck Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
    • Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Abstract

Background

This study was designed to identify the factors associated with the outcome after standard treatment with surgery and postoperative radiotherapy (RT) for locally advanced salivary gland cancers.

Methods

We conducted a retrospective review of patients with salivary gland cancers registered in the University of Pittsburgh databases from 1990 to 2006.

Results

A total of 74 patients were analyzed. Histologic types included salivary duct carcinoma, 24%; adenoid cystic carcinoma, 23%; and adenocarcinoma, 19%; N2, 39%; N0–1, 58%; and major salivary gland origin, 80%. With a median follow-up of 4.1 years, the 5-year recurrence-free survival (RFS) was 49%, and the 5-year overall survival (OS) was 55%. The 5-year local RFS was 76% and the 5-year distant RFS was 60%. Using Cox-regression analysis, advanced N classification (N2) was the only significant predictor of both RFS and OS.

Conclusion

The long-term survival of patients with high-risk, locally advanced salivary gland cancers is unsatisfactory. Advanced nodal disease is strongly associated with patient outcome and should be considered as a stratification factor in future trials in locally advanced salivary gland cancers. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

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