Mortality rates and prognostic factors in patients with malignant salivary tumors
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Malignancies of the salivary glands represent a multifarious disease. Evaluating the prognostic factors of these malignancies may help predict patient outcome and aid decision-making in choosing the most suitable therapy. We examined the role of various salivary tumorigenic, clinical and therapeutic features in a cohort of 101 patients diagnosed and treated for primary malignant salivary tumors. These include histo-pathological diagnosis, stage, grade and T, N, M values as well as the existence of perineural invasion and extra-parenchymal spread. We also identified the salivary gland involved, the sub-compartment specific location of the tumor and the therapy administered. All these were related to mortality. Of the 101 patients examined, 79 survived and 22 died due to the disease. Tumor staging, distant metastasis and perineural invasion were highly significant predictors of increased lethality. Histo-pathological grading was also a predictor but to a lesser degree. Neither neck metastasis nor tumor size or type had a significant impact on lethality. Performing neck dissections did not decrease lethality rate. Location of the tumor in the parotid gland and more so in its deep lobe adversely affected lethality; extra-parenchymal spread also had an adverse effect. Our results seem to indicate hematogenous rather than lymphogenous spread of metastasis from malignant salivary tumors. The highest therapeutic priority should be achieving full local control of the disease by safe removal of the primary salivary tumor, accompanied by regional control of perineural invasion and extra-parenchymal spread and appropriate systemic treatment aimed at eradicating distant metastasis.
KeywordsSalivary tumors Mortality Stage Distant metastasis Grade Adjuvant therapy
Thie study received no funding.
Compliance with ethical standards
Conflicts of interest
The authors declare no conflicts of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Spiro RH. Factors affecting survival in salivary gland cancers. In: McGurk M, Renehan A, editors. Controversies in the management of salivary gland disease, Oxford: Oxford University Press; 2001. pp. 143–50.Google Scholar
- 3.McGurk M. Management of salivary gland cancer: clinically or pathologically based? Overview. In: McGurk M, Renehan A, editors. Controversies in the management of salivary gland disease, Oxford: Oxford University Press; 2001. pp. 155–61.Google Scholar
- 5.Slevin N, Frankenthaler R. The role of radiotherapy in the management of salivary gland cancer. In: McGurk M, Renehan A, editors. Controversies in the management of salivary gland disease, Oxford: Oxford University Press; 2001. pp. 163–72.Google Scholar
- 6.Bjørndal K, Krogdahl A, Therkildsen MH, et al. Salivary gland carcinoma in Denmark 1990–2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol. 2011;47(7):677–82. https://doi.org/10.1016/j.oraloncology.2011.04.020.CrossRefPubMedGoogle Scholar
- 11.Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumors: pathology and genetics of head and neck tumors, Lyon: IARC Press; 2005.Google Scholar
- 19.Nagler RM, Kerner H, Laufer D, Ben-Eliezer S, Minkov I, Ben-Itzhak O. Squamous cell carcinoma of the tongue: the prevalence and prognostic roles of p53, Bcl-2, c-erbB-2 and apoptotic rate as related to clinical and pathological characteristics in a retrospective study. Cancer Lett. 2002;186(2):137-50.CrossRefGoogle Scholar