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. 2019 Apr 23;14(1):68.
doi: 10.1186/s13014-019-1260-x.

Salivary gland carcinoma (SGC) with perineural spread and/or positive resection margin - high locoregional control rates after photon (chemo) radiotherapy - experience from a monocentric analysis

Marlen Haderlein  1 , Claudia Scherl  2   3 , Sabine Semrau  4 , Sebastian Lettmaier  4 , Markus Hecht  4 , Florian Putz  4 , Heinrich Iro  2 , Abbas Agaimy  5 , Rainer Fietkau  4
Affiliations

Salivary gland carcinoma (SGC) with perineural spread and/or positive resection margin - high locoregional control rates after photon (chemo) radiotherapy - experience from a monocentric analysis

Marlen Haderlein et al. Radiat Oncol. .

Abstract

Background: The aim was to evaluate the outcome, especially locoregional control of patients with locally advanced salivary gland carcinoma (SGC) with perineural spread (Pn1) and/or positive resection margins (R1/2) after postoperative photon (chemo) radiotherapy in a single centre.

Methods: We retrospectively reviewed data of 65 patients with newly diagnosed locally advanced SGC without distant metastases who underwent radio (chemo) therapy in the department of radiation oncology of the university hospital of Erlangen from January 2000 until April 2017. Kaplan Meier method was used to calculate survival and recurrence rates. In univariate analysis the log-rank test was used to correlate patient-/tumor- and treatment-related parameters to survival and recurrence rates.

Results: Median follow-up was 45 months (range: 6; 215). After 1, 3, 5 years cumulative incidence of local and locoregional failure was 3.1, 7.0, 7.0% and 3.1, 9.7, 12.9%, whereas cumulative incidence of distant metastases (DM) was 15.6, 36.0, 44.0%. After 1,3, 5 years cumulative Overall (OS) and Disease-free survival (DFS) was 90.5, 74.9, 63.9% and 83.0, 54.8, 49.4%. The only significant predictor for decreased local and locoregional control was a macroscopic resection margin(R2) (p = 0.002 and p = 0.04). High-grade histology (p = 0.006), lymph node metastases with extracapsular spread (p = 0.044) and an advanced T-stage (p = 0.031) were associated with an increased rate of DM. High-grade histology was the only factor predicting for a decreased DFS (p = 0.014).

Conclusion: Photon radiotherapy leads to high local and locoregional control rates in a high-risk patient population with SGC with microscopically positive resection margins and/or perineural spread. The most common site of disease recurrence was distant metastases. Therefore the real challenge for the future should be to prevent distant metastases.

Keywords: Locoregional control; Perineural spread; Photon radiotherapy; Positive resection margin; Salivary gland cancer.

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Conflict of interest statement

Ethics approval and consent to participate

For this type of study ethics approval is not required.

Written informed consent was obtained ‘front door’ from all patients allowing collection of their clinical data.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Cumulative incidence of local recurrence
Fig. 2
Fig. 2
Cumulative incidence of locoregional recurrence
Fig. 3
Fig. 3
Cumulative incidence of local (3a) and locoregional (3b) recurrence according to resection margin
Fig. 4
Fig. 4
Disease-free survival
Fig. 5
Fig. 5
Cumulative incidence of distant metastases
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