Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 20;18(1):672.
doi: 10.1186/s12885-018-4578-0.

Treatment outcomes in metastatic and localized high-grade salivary gland cancer: high chance of cure with surgery and post-operative radiation in T1-2 N0 high-grade salivary gland cancer

Jeon Yeob Jang  1 , Nayeon Choi  2 , Young-Hyeh Ko  3 , Man Ki Chung  2 , Young-Ik Son  2 , Chung-Hwan Baek  2 , Kwan-Hyuck Baek  4 , Han-Sin Jeong  5
Affiliations

Treatment outcomes in metastatic and localized high-grade salivary gland cancer: high chance of cure with surgery and post-operative radiation in T1-2 N0 high-grade salivary gland cancer

Jeon Yeob Jang et al. BMC Cancer. .

Abstract

Background: High-grade salivary gland cancer is a distinct clinical entity that has aggressive disease progression and early systemic spread. However, because of the rarity of the disease, the clinical outcomes, prognostic factors and clinical decision on the optimal treatments have not been fully understood.

Methods: In this study, we retrospectively analyzed the clinical data of 124 patients with high-grade salivary gland cancers and performed multivariate survival analyses to evaluate the clinico-pathological factors affecting the treatment outcomes.

Results: The 5-year disease-specific survival was 63.4% in patients with high-grade salivary gland cancers. Among the clinico-pathological factors, presence of lymph node metastasis (hazard ratio 5.63, 95% confidence interval 2.64-12.03, P < 0.001) and distant metastasis (hazard ratio 4.59, 95% confidence interval 2.10-10.04, P < 0.001) at diagnosis were the most potent unfavorable prognostic factors. Importantly, patients with early-stage disease (T1-2N0M0) showed apparently a relatively excellent prognosis (93.2% 5-year disease-specific survival); meanwhile N (+) and M1 status at diagnosis resulted in dismal outcomes (44.6 and 21.1% 5-year disease-specific survival, respectively). On comparing surgery alone as a treatment modality, surgery plus postoperative radiation significantly benefited the patients, but the difference between adjuvant radiation and chemoradiation was not found to be significant. Pathological subtypes of high-grade salivary gland cancers were not significantly associated with prognosis.

Conclusions: Despite of an overall unfavorable prognosis in high-grade salivary gland cancer, patients with early-stage disease are expected to have excellent prognosis (over 90% survival rates) with surgery plus adjuvant radiation, which may implicate the patients' consultation, therapeutic decision making, and the need for early detection of the disease.

Keywords: High-grade pathology; Prognosis; Salivary gland neoplasm; Treatment outcomes.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Institutional Review Board of Samsung Medical Center. The written informed consent was not required for this retrospective study. The data used in this study was de-identified.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Survival curves according to the tumor-node-metastasis staging in patients with high-grade salivary gland cancers
Fig. 2
Fig. 2
Comparison of survivals between the two treatment strategies: surgery plus post-operative radiation versus surgery plus post-operative radiation and chemotherapy for high-grade salivary gland cancer
Fig. 3
Fig. 3
Comparison of survivals in patients diagnosed with salivary duct carcinomas and non-salivary duct carcinoma pathologies
Fig. 4
Fig. 4
Tumor grade-based management strategy for salivary gland tumors 1Cytology: Reference [7], 2Risk factors: Reference [9], 3chemoradiation: requires further clinical validation
See this image and copyright information in PMC

References

    1. Spiro RH. Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head & neck surgery. 1986;8(3):177–184. doi: 10.1002/hed.2890080309. - DOI - PubMed
    1. de Ridder M, Balm AJ, Smeele LE, Wouters MW, van Dijk BA. An epidemiological evaluation of salivary gland cancer in the Netherlands (1989-2010) Cancer Epidemiol. 2015;39(1):14–20. doi: 10.1016/j.canep.2014.10.007. - DOI - PubMed
    1. El-Naggar AK. Tumours of salivary glands. In: El-Naggar AK, JKC C, Grandis JR, Takata T, Slootweg PJ, editors. WHO Classification of Head and Neck Tumours. Lyon, France: WHO Press; 2017. pp. 159–202.
    1. Seethala RR, Stenman G. Update from the 4th edition of the World Health Organization classification of head and neck Tumours: tumors of the salivary gland. Head and neck pathology. 2017;11(1):55–67. doi: 10.1007/s12105-017-0795-0. - DOI - PMC - PubMed
    1. Adelstein DJ, Koyfman SA, El-Naggar AK, Hanna EY. Biology and management of salivary gland cancers. Semin Radiat Oncol. 2012;22(3):245–253. doi: 10.1016/j.semradonc.2012.03.009. - DOI - PubMed

MeSH terms