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Punita L, Naik N, Prasad P, Kesari A, Shankar R, Kumar A, Kapoor V, Kumar S, Rastogi N, Agrawal S, Mishra S. Salivary gland tumors: an audit from a tertiary care centre in Northern India. Indian J Otolaryngol Head Neck Surg 2024; 76:2660-2674. [PMID: 38883502 PMCID: PMC11169334 DOI: 10.1007/s12070-023-04348-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 06/18/2024] Open
Abstract
Salivary gland tumors are relatively rare and can exhibit various clinical behaviors. The study aims to understand the natural history, pathology, diagnostic workup, and treatment strategies for these tumors to improve patient outcomes. The audit included patients with salivary gland tumors detected through radiology or cytology. Patients underwent surgery, with some receiving adjuvant treatment. Demographic information, treatment interventions, and survival outcomes were analyzed using SPSS software. A total 89 as malignant salivart gland tumours were audited Malignant tumors were predominantly found in the parotid gland, with fewer cases in the minor salivary gland and submandibular gland.The median age of presentation was 47 years, and the majority of patients were male. The study examined various pathological and clinical factors, including tumor stage, nodal status, and the presence of facial palsy. Surgical procedures and histological types of tumors were documented. Adverse histological features like positive margins, lymph node positivity, lympho-vascular invasion, extracapsular spread, and perineural invasion were noted. POSTOP RT was administered to high-risk patients. Most malignant salivary gland tumors were found in the parotid gland, while minor salivary gland tumors were underrepresented in the audit. Surgical practices were diverse. Radiotherapy protocols were relatively standardized. The study found that certain histological features, such as lymph node positivity, margin positivity, lympho-vascular invasion, perineural invasion, and extracapsular spread, were associated with adverse effects on DFS and OS. The findings suggest that specific histological features, including LVI and ECE have emerged as independent prognostic factors for DFS and OS.
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Affiliation(s)
- L Punita
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
| | - Nagendra Naik
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
| | - Pallavi Prasad
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India
| | - Amit Kesari
- Department of Neuro-Otology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India
| | - Ravi Shankar
- Department of Neuro-Otology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India
| | - Anoop Kumar
- Department of Biostatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India
| | - Vishwas Kapoor
- Department of Biostatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India
| | - Shaleen Kumar
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
| | - Neeraj Rastogi
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
| | - Sushma Agrawal
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
| | - Shagun Mishra
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India
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Wu WB, Cai WL, Zou YH, You R, Liu YP, Yuan ZD, Li Q, Li WC, Pi ZX, Xie YL, Wen K, Chen MY, Sun R. Outcomes of patients in nasopharyngeal adenoid cystic carcinoma in the IMRT era: a single-center experience. BMC Cancer 2024; 24:576. [PMID: 38730348 PMCID: PMC11084105 DOI: 10.1186/s12885-024-12159-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 03/21/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with special biological features. Controversies exist regarding the treatment approach and prognostic factors in the IMRT era. This study aimed to evaluate the long-term outcomes and management approaches in NACC. METHODS Fifty patients with NACC at our institution between 2010 and 2020 were reviewed. Sixteen patients received primary radiotherapy (RT), and 34 patients underwent primary surgery. RESULTS Between January 2010 and October 2020, a total of 50 patients with pathologically proven NACC were included in our analysis. The median follow-up time was 58.5 months (range: 6.0-151.0 months). The 5-year overall survival rate (OS) and progression-free survival rate (PFS) were 83.9% and 67.5%, respectively. The 5-year OS rates of patients whose primary treatment was surgery and RT were 90.0% and 67.3%, respectively (log-rank P = 0.028). The 5-year PFS rates of patients whose primary treatment was surgery or RT were 80.8% and 40.7%, respectively (log-rank P = 0.024). Multivariate analyses showed that nerve invasion and the pattern of primary treatment were independent factors associated with PFS. CONCLUSIONS Due to the relative insensitivity to radiation, primary surgery seemed to provide a better chance of disease control and improved survival in NACC. Meanwhile, postoperative radiotherapy should be performed for advanced stage or residual tumours. Cranial nerve invasion and treatment pattern might be important factors affecting the prognosis of patients with NACC.
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Affiliation(s)
- Wen-Bin Wu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Wu-Lin Cai
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Ye-Hao Zou
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Rui You
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - You-Ping Liu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Zhao-Di Yuan
- Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510060, China
| | - Qiong Li
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Wen-Chao Li
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Zhi-Xuan Pi
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Yu-Long Xie
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Kai Wen
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Ming-Yuan Chen
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China.
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
| | - Rui Sun
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China.
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
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Zhang ES, Hair BB, Lamarre ED, Koyfman SA, Burkey BB. Occult Nodal Metastases in Individuals with Clinically Node-Negative Salivary Gland Malignancies. Laryngoscope 2024; 134:1705-1715. [PMID: 37847121 DOI: 10.1002/lary.31119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/03/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Salivary gland malignancies comprise a heterogeneous group of pathologies, for which treatment of the clinically negative neck may vary depending on numerous factors. Herein we present data on occult nodal metastases (ONM) as well as survival and recurrence from a large series of cN0 salivary gland malignancies. METHODS Retrospective chart review was conducted on 532 patients, with 389 patients with major salivary gland cancers and 143 patients with minor salivary gland cancers. Demographic and treatment data were included and rates of ONM, overall survival, local recurrence, regional recurrence, and distant recurrence were analyzed. RESULTS We found that the overall rate of ONM for parotid was 27% (63/235), for submandibular/sublingual was 35% (18/52), and for minor was 15% (4/26). Analysis of ONM rate at each nodal level was also performed, finding higher rates of level IV and V ONM than prior studies. Submandibular/sublingual and minor salivary gland malignancies showed a predominance of ONMs at levels I-III. Our survival and recurrence rates were similar to those found in previous studies. CONCLUSION Our data also demonstrate a predominance of ONM in levels I-III for submandibular/sublingual and minor salivary gland cancers, suggesting elective dissection in these levels. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1705-1715, 2024.
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Affiliation(s)
- Emily S Zhang
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Bryan B Hair
- Department of Otolaryngology - Head and Neck Surgery, University Hospitals, Cleveland, Ohio, U.S.A
| | - Eric D Lamarre
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Shlomo A Koyfman
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Brian B Burkey
- Department of Otolaryngology, Cleveland Clinic Florida, Vero Beach, Florida, U.S.A
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Abbate V, Barone S, Borriello G, Troise S, Bonavolontà P, Pacella D, Vaira LA, Turri-Zanoni M, Cuéllar CN, Califano L, Dell' Aversana Orabona G. Diagnostic performance of inflammatory biomarkers and cytological analysis in salivary gland tumors. Head Neck 2023; 45:3015-3023. [PMID: 37752706 DOI: 10.1002/hed.27528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the diagnostic performance of serum inflammatory biomarkers in salivary gland tumors with dubious results following cytological analysis. METHODS A retrospective analysis of 239 cases following surgery between January 2011 and June 2022 was performed. Receiver Operating Characteristic curves were drawn and areas under the curves were computed to evaluate the diagnostic performance of the inflammatory biomarkers (SII, SIRI, PLR, and NLR). Optimal cut-offs for each marker were determined by maximizing the Youden index. RESULTS Analysis showed that among the major biomarkers examined, SIRI performed an AUC of 0.77. The best SIRI cut-off was 0.94 with an accuracy of 79.9%. The accuracy, sensitivity, and specificity of cytological analysis were 77.8%, 59.6%, and 90.7% respectively. By combining SIRI with cytological analysis we demonstrated an increase in sensitivity to 82.8%. CONCLUSIONS Inflammatory biomarkers could be evaluated to support the diagnosis and treatment of salivary gland tumors in difficult cases.
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Affiliation(s)
- Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Simona Barone
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Gerardo Borriello
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Stefania Troise
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Mario Turri-Zanoni
- ENT Unit, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo Via Guicciardini, Varese, Italy
| | - Carlos Navarro Cuéllar
- Division of Oral and Maxillofacial Surgery, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanni Dell' Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
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Preston P, Esebua M, Layfield LJ. Diagnosis of salivary gland tumors: Does the triple diagnosis method have value? Diagn Cytopathol 2023; 51:527-531. [PMID: 37260131 DOI: 10.1002/dc.25171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Appropriate clinical management of salivary gland lesions requires a determination as to whether a salivary gland nodule is benign or malignant. Approximately three-quarters of all salivary gland nodules represent benign neoplasms. Separation of salivary gland carcinomas from benign lesions can be diagnostically challenging. The Milan System for Reporting Salivary Gland Cytopathology recommends the correlation of cytologic diagnoses with imaging and clinical findings creating a diagnostic triplet. How often the "Triple Diagnosis" method is used and its accuracy in separating salivary gland nodules into benign and malignant groups are unknown. METHODS An electronic records search of cytology files at the University of Missouri was performed for fine needle aspirates of the salivary gland obtained between September 2018 and August 2022. Chart review was performed for preoperative clinical and imaging diagnoses. Diagnostic "Triplets" constructed from cytologic, clinical, and imaging diagnoses were correlated with final surgical pathology diagnosis. RESULTS One hundred and thirty-six FNAs were identified. Eighty-seven cases had preoperative imaging with 52 of these cases having clinical diagnoses. Due to the lack of a definitive clinical or imaging diagnosis for a nodule as benign or malignant, only 12 (23%) cases had definitive "Triplets." Nine (17%) "Triplets" were benign and three (6%) were malignant. Accuracy of concordant triplets was 100% for the prediction of malignancy and 89% for the prediction of a benign result as determined by final histologic diagnoses. CONCLUSION While highly accurate in predicting the benign or malignant nature of a salivary gland nodule, concordant triplets made up only 23% of cases limiting their clinical utility.
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Affiliation(s)
- Peace Preston
- Department of Pathology and Anatomical Science, University of Missouri, Columbia, Missouri, USA
| | - Magda Esebua
- Department of Pathology and Anatomical Science, University of Missouri, Columbia, Missouri, USA
| | - Lester J Layfield
- Department of Pathology and Anatomical Science, University of Missouri, Columbia, Missouri, USA
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Kazemi MA, Amini F, Kargar B, Lotfi M, Aghazadeh K, Sharifian H, Moradi B, Azadbakht J. The Value of Ultrasound-guided Core Needle Biopsy in Differentiating Benign from Malignant Salivary Gland Lesions. Indian J Otolaryngol Head Neck Surg 2023; 75:266-270. [PMID: 37275055 PMCID: PMC10235295 DOI: 10.1007/s12070-022-03148-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 08/19/2022] [Indexed: 06/07/2023] Open
Abstract
Purpose In recent years, core needle biopsy (CNB) technique has received much attention, being used as alternative method of tissue sampling for surgical biopsy of salivary gland tumors (SGTs). The present study aimed to evaluate the value of CNB in differentiating benign from malignant SGTs. Materials and methods Patients with suspected benign or malignant SGTs in imaging were enrolled in this study. All core needle biopsies were performed under ultrasound guidance, i.e. ultrasound-guided Core Needle Biopsy (USCNB). Histological examination of the specimen after surgical excision was regarded as gold standard test and set as reference standard to assess USCNB accuracy for discriminating between ultrasound-visible benign and malignant SGTs. Results Based on USCNB results, from 36 participants (14 women and 22 men) with SGTs, 44.4% of detected tumors were benign and 55.5% were malignant. Twenty-two patients underwent surgery and postoperative specimen histological examination showed that 59% of excised lesions were benign and 41% were malignant. USCNB and surgical biopsy (SB) findings were completely compatible for 21 patients. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of USCNB were 100% in differentiating malignant from benign lesions. Conclusion USCNB is a valuable and accurate method of diagnosis with high sensitivity and specificity in distinguishing benign from malignant ultrasound-visible SGTs.
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Affiliation(s)
- Mohammad Ali Kazemi
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Amini
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Kargar
- Faculty of medicine, Islamic Azad University Tehran Medical Sciences, Tehran, Iran
| | - Maryam Lotfi
- Department of Pathology, Amiralam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyvan Aghazadeh
- Otorhinolaryngology research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Moradi
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Women’ Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javid Azadbakht
- Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Shahid Beheshti Hospital, Qotb Ravandi Blvd, 8715981151 Kashan, Iran
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Nishimura H, Jin D, Kinoshita I, Taniuchi M, Higashino M, Terada T, Takai S, Kawata R. Increased Chymase-Positive Mast Cells in High-Grade Mucoepidermoid Carcinoma of the Parotid Gland. Int J Mol Sci 2023; 24:ijms24098267. [PMID: 37175975 PMCID: PMC10179695 DOI: 10.3390/ijms24098267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
It has long been known that high-grade mucoepidermoid carcinoma (MEC) has a poor prognosis, but the detailed molecular and biological mechanisms underlying this are not fully understood. In the present study, the pattern of chymase-positive mast cells, as well as chymase gene expression, in high-grade MEC was compared to that of low-grade and intermediate-grade MEC by using 44 resected tumor samples of MEC of the parotid gland. Chymase expression, as well as chymase-positive mast cells, was found to be markedly increased in high-grade MEC. Significant increases in PCNA-positive cells and VEGF gene expression, as well as lymphangiogenesis, were also confirmed in high-grade MEC. Chymase substrates, such as the latent transforming growth factor-beta (TGF-β) 1 and pro-matrix metalloproteinase (MMP)-9, were also detected immunohistologically in high-grade MEC. These findings suggested that the increased chymase activity may increase proliferative activity, as well as metastasis in the malignant condition, and the inhibition of chymase may be a strategy to improve the poor prognosis of high-grade MEC of the parotid gland.
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Affiliation(s)
- Hiromi Nishimura
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Denan Jin
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Ichita Kinoshita
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Masataka Taniuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Masaaki Higashino
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Shinji Takai
- Department of Innovative Medicine, Graduate School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki-City 569-8686, Osaka, Japan
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Facial nerve dysfunction following parotidectomy: role of intraoperative facial nerve monitoring. Eur Arch Otorhinolaryngol 2023; 280:1479-1484. [PMID: 36333562 DOI: 10.1007/s00405-022-07720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Facial nerve dysfunction (FND) is a frequent and serious parotidectomy outcome. Intraoperative facial nerve monitoring (IFNM) is an increasingly used technique to identify the facial nerve (FN) and minimize its injury. This study aimed to evaluate the determinant factors in the presence and severity of FND after parotidectomy, including IFNM. STUDY DESIGN, SETTING AND METHODS A total of 48 patients consecutively submitted to parotidectomy between 2005 and 2020 in a tertiary hospital were retrospectively analyzed. The House-Brackmann Scale (HBS) was used to assess the severity of FND. RESULTS There was a mean age of 54.2 ± 17.8 years, 50% were male. Pleomorphic adenoma (41.7%) and Warthin's tumor (25.0%) were most common. From the 23 patients (47.9%) who developed some degree of FND (HBS score of 3.41 ± 1.53), 19 (82.6%) showed facial movement recovery, with a mean recovery time of 4.78 ± 2.53 months. IFNM was performed in 39.6% of the surgeries. The use of IFNM (p = 0.514), the type of surgery-partial or total parotidectomy-(p = 0.853) and the type of histology-benign or malignant lesion-(p = 0.852) did not significantly influence the presence of FND in the postoperative period. However, in the subgroup of patients who developed FND, the HBS value was significantly lower in cases of benign pathology (p = 0.002) and in patients who underwent IFNM (p = 0.017), denoting a significantly lower severity. CONCLUSION In the present study, IFNM and the existence of a benign lesion have been shown to be associated with lower severity of FND.
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Grasl S, Janik S, Faisal M, Grasl MC, Pammer J, Weinreb I, Fischer G, Kim J, Hosni A, de Almeida JR, Goldstein DP, Erovic BM. Influence of Grading on Management and Outcome in Mucoepidermoid Carcinoma of the Parotid-A Multi-institutional Analysis. Laryngoscope 2023; 133:124-132. [PMID: 35475580 DOI: 10.1002/lary.30135] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate clinical outcome of low (G1), intermediate (G2), and high-(G3) grade mucoepidermoid carcinomas (MEC) of the parotid gland. STUDY DESIGN Retrospective chart review including 212 patients. Clinicopathological data was statistically analyzed regarding grading, overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS). RESULTS 105 (49.5%) G1, 73 (34.5%) G2, and 34 (16%) G3 MEC were included and 56 (26.4%) patients presented with neck node metastases. The risk of occult nodal metastases was significantly associated with grading and increased from 9.2% in G1 to 26.7% and 27.8% in G2 and G3 tumors, respectively (p = 0.008). Elective periparotid and cervical lymph node dissection was performed in 170 (80.2%) and 70 (33%) patients, respectively. All patients with positive periparotid nodes when subjected to an additional neck dissection had associated cervical neck node involvement (p < 0.001). Grading was an independent significant prognostic factor for OS (HR 4.05; 95%CI: 1.15-14.35; p = 0.030) and DSS (HR 17.35; 95%CI: 1.10-273.53; p = 0.043). In a subgroup analysis, elective neck dissection (END) was also significantly associated with a better DFS (p = 0.041) in neck node-negative G1 MECs. CONCLUSION The risk of occult nodal metastasis in intermediate-grade MEC is as high as in high-grade MEC and that END in G1 tumors is associated with a prolonged DFS. Additionally, periparotid node involvement seems to be a predictor for positive neck node involvement. This study presents some preliminary data to consider END in clinically neck node negative patients with parotid MEC; however, larger series are needed. LEVEL OF EVIDENCE 3 Laryngoscope, 133:124-132, 2023.
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Affiliation(s)
- Stefan Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Muhammad Faisal
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.,Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria
| | - Matthaeus C Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Johannes Pammer
- Clinical Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Gregor Fischer
- Department of Otolaryngology, Karl Landsteiner University Hospital, Krems, Austria
| | - John Kim
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria
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10
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Colombo E, Van Lierde C, Zlate A, Jensen A, Gatta G, Didonè F, Licitra LF, Grégoire V, Vander Poorten V, Locati LD. Salivary gland cancers in elderly patients: challenges and therapeutic strategies. Front Oncol 2022; 12:1032471. [PMID: 36505842 PMCID: PMC9733538 DOI: 10.3389/fonc.2022.1032471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Salivary gland carcinomas (SGCs) are the most heterogeneous subgroup of head and neck malignant tumors, accounting for more than 20 subtypes. The median age of SGC diagnosis is expected to rise in the following decades, leading to crucial clinical challenges in geriatric oncology. Elderly patients, in comparison with patients aged below 65 years, are generally considered less amenable to receiving state-of-the-art curative treatments for localized disease, such as surgery and radiation/particle therapy. In the advanced setting, chemotherapy regimens are often dampened by the consideration of cardiovascular and renal comorbidities. Nevertheless, the elderly population encompasses a broad spectrum of functionalities. In the last decades, some screening tools (e.g. the G8 questionnaire) have been developed to identify those subjects who should receive a multidimensional geriatric assessment, to answer the question about the feasibility of complex treatments. In the present article, we discuss the most frequent SGC histologies diagnosed in the elderly population and the relative 5-years survival outcomes based on the most recent data from the Surveillance, Epidemiology, and End Results (SEER) Program. Moreover, we review the therapeutic strategies currently available for locoregionally advanced and metastatic disease, taking into account the recent advances in precision oncology. The synergy between the Multidisciplinary Tumor Board and the Geriatrician aims to shape the most appropriate treatment pathway for each elderly patient, focusing on global functionality instead of the sole chronological age.
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Affiliation(s)
- Elena Colombo
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Charlotte Van Lierde
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Alexandra Zlate
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Alexandra Jensen
- Department of Radiation Oncology, University Hospitals Giessen and Marburg (UKGM), Marburg, Germany
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabio Didonè
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa F. Licitra
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Vincent Grégoire
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Vander Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Laura D. Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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11
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Ho NX, O'Meara S, Moran T, McGuire B. A curious case of metastatic parotid adenoid cystic carcinoma to kidney. BMJ Case Rep 2022; 15:e248833. [PMID: 36307140 PMCID: PMC9621166 DOI: 10.1136/bcr-2022-248833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A woman in her 60s presented with a 2-week history of non-specific left-sided abdominal pain. She previously underwent a total parotidectomy and adjuvant radiotherapy for left parotid adenoid cystic carcinoma 13 years prior, with a local recurrence 4 years after. Investigations revealed a large left-sided renal mass with appearances of renal carcinoma and no signs of metastatic disease. Pathology following nephrectomy revealed a metastatic adenoid cystic carcinoma.Metastatic disease recurred 11 months postradical nephrectomy to the contralateral kidney and lung, and she was referred to medical oncology for further management.This case history demonstrates the highly aggressive nature of an adenoid cystic carcinoma primary of salivary gland origin with rare metastasis to the kidney.
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Affiliation(s)
- Ning Xuan Ho
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Sorcha O'Meara
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland
| | - Tom Moran
- Department of Otolaryngology/Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Otolaryngology/Head and Neck Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Barry McGuire
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland
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12
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Du Y, Zeng Y. Analysis of postoperative radiotherapy for non-metastatic head and neck adenoid cystic carcinoma based on SEER data. J Int Med Res 2022; 50:3000605221115151. [PMID: 35929027 PMCID: PMC9358576 DOI: 10.1177/03000605221115151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The postoperative role of adjuvant radiotherapy in non-metastatic head and neck adenoid cystic carcinoma (ACC) remains controversial. We analyzed adjuvant radiotherapy's effect on surgical patient survival. METHODS Patients diagnosed with ACC from 2004 to 2015 in the Surveillance, Epidemiology, and End Results database were analyzed. The overall survival (OS) and disease-specific survival (DSS) of patients after adjuvant radiotherapy were assessed using the Kaplan-Meier and multivariate Cox methods. Propensity score matching (PSM) was performed to adjust confounders between patients with or without adjuvant radiotherapy; a forest plot was generated by subgroup analysis. RESULTS The study included 742 patients. In the PSM cohort, adjuvant radiotherapy did not improve OS or DSS. Radiotherapy was not a protective factor for OS or DSS in the univariate and multivariate Cox proportional hazard models. In the subgroup analysis, postoperative radiotherapy improved the OS of female and N1-stage patients and those with oropharyngeal tumors or over 79 years and the DSS of N1-stage patients. CONCLUSIONS Postoperative radiotherapy showed different benefits in ACC patients, and postoperative radiotherapy recommendations should be individualized. Female and N1-stage ACC patients and those with oropharyngeal tumors or patients over 79 years without distant metastases postoperatively could benefit from adjuvant radiotherapy.
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Affiliation(s)
- Yan Du
- Department of Oncology, Dujiangyan People's Hospital, Dujiangyan Sichuan, China
| | - Yong Zeng
- Department of Oncology, Dujiangyan People's Hospital, Dujiangyan Sichuan, China
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13
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Rui X, Huang Z, Chen R, Chen Y, Wang Y, Huang Z. RPS3 Promotes the Metastasis and Cisplatin Resistance of Adenoid Cystic Carcinoma. Front Oncol 2022; 12:804439. [PMID: 35847905 PMCID: PMC9280127 DOI: 10.3389/fonc.2022.804439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background Adenoid cystic carcinoma (ACC) is a malignant tumor in salivary gland tissue, that is characterized by strong invasiveness and lung metastasis, leading to poor survival rates. RPS3 is been reported to be associated with the biological functions of tumor cells. This study explored the regulatory effect of RPS3 in ACC to provide new therapeutic targets for ACC therapy. Methods We reviewed the clinical and pathologic data of 73 ACC patients. The expression of RPS3 was examined in ACC by immunohistochemistry. Transwell, wound healing, half-maximal inhibitory concentration (IC50) and other experiments were used to determine the regulatory effect of RPS3 on ACC functions. Coimmunoprecipitation and mass spectrometry analysis were used to detect the binding proteins of RPS3, mechanisms by which RPS3/STAT1/NF-kB signaling regulates ACC behavior were assessed using western blotting (WB), qPCR, etc. To explore the regulatory effect of RPS3 on ACC in vivo, we constructed nude mouse sciatic nerve infiltration model and a lung metastasis model for studies. Results High RPS3 expression was associated with metastasis and a poor prognosis in ACC patients. Inhibition of RPS3 expression reduced ACC migration, invasion and cisplatin resistance, and overexpression of RPS3 promoted ACC migration, invasion and cisplatin resistance. Further experiments revealed that RPS3 can activate the STAT1/NF-kB signaling pathway and regulate ACC behavior through binding to STAT1. The incidence of sciatic nerve infiltration and lung metastasis in nude mice after RPS3 knockdown was lower than that of the control group in vivo. Conclusion RPS3 is highly expressed and associated with the prognosis and survival of ACC patients. The RPS3/STAT1/NF-kB pathway may play an important regulatory role in ACC migration, invasion and chemoresistance. As a new therapeutic target of ACC, its clinical application value is worthy of attention and further exploration.
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Affiliation(s)
- Xi Rui
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zixian Huang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rui Chen
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yongju Chen
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Zhiquan Huang, ; ; Yan Wang,
| | - Zhiquan Huang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Zhiquan Huang, ; ; Yan Wang,
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14
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Mantsopoulos K, Iro H. [Surgery for parotid gland cancer-controversial and proven aspects]. HNO 2022; 71:215-222. [PMID: 35579674 DOI: 10.1007/s00106-022-01182-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Due to the rarity of primary parotid malignancies, there are currently only limited clinical study data on the optimal surgical therapy. Parotid malignancies encompass a broad spectrum of more than 20 different histological subtypes with varying biology, which thus represents a challenge for even experienced pathologists and head and neck surgeons with proven expertise in salivary gland surgery. OBJECTIVE The aim of this review article is to provide an overview of the current literature on surgical therapy of the primary tumor and the cN0 neck as well as treatment of the facial nerve, and to shed light on the various controversial aspects of this topic. RESULTS In salivary gland oncology there is a trend towards safe (R0) but more conservative surgery. Currently, less-invasive surgical approaches could potentially be applied in a small subgroup with carefully selected caudally located and R0-resected "low-grade tumors" in stages T1-T2 and cN0 in relatively young patients with high compliance and more in the context of structured clinical studies. Elective neck dissection in the case of cN0 status should be carried out if risk factors for occult cervical lymph node metastasis (T3-T4a, "high-grade subtypes," advanced age, lymphangitic carcinomatosis) are present. In cases of small "low-grade parotid carcinomas," narrow resection margins or even microscopic tumor residues on the facial nerve can potentially be adequately compensated with adjuvant radiation therapy. However, due to the lack of solid data, the significance of the actual effect of the radiation in this situation should be viewed with great caution.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen-Nürnberg, Waldstr. 1, 91054, Erlangen, Deutschland.
| | - Heinrich Iro
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen-Nürnberg, Waldstr. 1, 91054, Erlangen, Deutschland
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15
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Mantsopoulos K, Bessas Z, Sievert M, Müller SK, Koch M, Agaimy A, Iro H. Frozen Section of Parotid Gland Tumours: The Head and Neck Pathologist as a Key Member of the Surgical Team. J Clin Med 2022; 11:jcm11051249. [PMID: 35268341 PMCID: PMC8911507 DOI: 10.3390/jcm11051249] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction: The aim of this study was to evaluate the impact of subspecialised head and neck versus general surgical pathologists on the reliability of the histopathologic evaluation during intraoperative consultation. Materials and Methods: The medical records of all patients who underwent a parotidectomy with frozen section between 2006 and 2021 were retrospectively evaluated. The frozen section was evaluated for sensitivity, specificity, accuracy, and predictive value. Assessment by two groups of pathologists (subspecialised head and neck versus general surgical pathologists) was compared, and the nature or types of misdiagnoses compared with final diagnoses on paraffin sections were analysed for the two groups. Results: Our study sample was made up of 669 cases. The mean age of patients was 57.7 years (range: 10−94 years). Of these, 490 patients had a benign lesion (73.2%), whereas 179 patients had a malignant lesion (26.8%). Frozen section had an overall accuracy of 97.6%, sensitivity for malignancy was 91.1%, specificity was 100%, PPV was 100%, and the NPV was 96.8%. The exact histologic subtype in the group of malignant tumours was correctly identified in FS in 89.4% of cases. A comparison of head and neck pathologists versus general surgical pathologists revealed a highly statistically significant difference concerning both overall detection of malignancy (p < 0.001) as well as correct identification of the histologic subtype (p < 0.001). Conclusion: Involvement of subspecialised head and neck pathologists in the intraoperative consultation for salivary gland tumours results in a gain of 19.8% more sensitivity, underlining the importance of specialisation in salivary gland pathology for the optimisation of frozen section quality.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
- Correspondence: ; Tel.: +49-(0)-9131-8533156; Fax: +49-(0)-9131-8533833
| | - Zacharias Bessas
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Sarina Katrin Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (Z.B.); (M.S.); (S.K.M.); (M.K.); (H.I.)
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16
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Current Issues in Treatment of Parotid Gland Cancer and Advanced Surgical Technique of Robotic Parotidectomy. Curr Oncol Rep 2022; 24:203-208. [DOI: 10.1007/s11912-021-01167-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/03/2022]
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17
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The Offprint of an Abnormal Pre-Parotidectomy Electrodiagnostic Finding in a Normally Functioning Facial Nerve: Correlation with Intraoperative Findings, Histology and Postoperative Facial Nerve Function. J Clin Med 2022; 11:jcm11010248. [PMID: 35011988 PMCID: PMC8746093 DOI: 10.3390/jcm11010248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to search for associations between an electrodiagnostically abnormal but clinically normal facial nerve before parotidectomy and the intraoperative findings, as well as the postoperative facial nerve function. The records of all patients treated for parotid tumors between 2002 and 2021 with a preoperative House–Brackmann score of grade I but an abnormal electrophysiologic finding were studied retrospectively. A total of 285 patients were included in this study, and 222 patients had a benign lesion (77.9%), whereas 63 cases had a malignant tumor (22.1%). Electroneurographic facial nerve involvement was associated with nerve displacement in 185 cases (64.9%) and infiltration in 17 cases (6%). In 83 cases (29.1%), no tumor–nerve interface could be detected intraoperatively. An electroneurographic signal was absent despite supramaximal stimulation in 6/17 cases with nerve infiltration and in 17/268 cases without nerve infiltration (p < 0.001). The electrophysiologic involvement of a normal facial nerve is not pathognomonic for a malignancy (22%), but it presents a rather rare (~6%) sign of a “true” nerve infiltration and could also appear in tumors without any contact with the facial nerve (~29%). Of our cases, two thirds of those with an anatomic nerve preservation and facial palsy had already directly and postoperatively recovered to a major extent in the midterm.
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18
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Kim TH, Eun YG, Lee YC. A machine learning based survival prediction model for advanced parotid gland mucoepidermoid carcinoma. Oral Oncol 2021; 124:105664. [PMID: 34896894 DOI: 10.1016/j.oraloncology.2021.105664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/08/2021] [Accepted: 12/01/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Tae Hoon Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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19
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Fatehi KS, Malik A. Elective neck dissection and its extent in salivary gland cancers: A dilemma. Head Neck 2021; 43:2859-2860. [PMID: 34145923 DOI: 10.1002/hed.26777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Akshat Malik
- Surgical Oncology, Max Super Specialty Hospital, Delhi, India
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20
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Westergaard-Nielsen M, Godballe C, Grau Eriksen J, Larsen SR, Kiss K, Agander T, Parm Ulhøi B, Wittenborg Charabi B, Ehlers Klug T, Jacobsen H, Johansen J, Kristensen CA, Andersen E, Andersen M, Bjørndal K. Surgical treatment of the neck in patients with salivary gland carcinoma. Head Neck 2021; 43:1898-1911. [PMID: 33733522 DOI: 10.1002/hed.26667] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines. METHODS Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence-free survival was calculated using the Kaplan-Meier method. RESULTS Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high-grade histology tumors. In multivariate analyses, high-grade histology and vascular invasion were associated with occult metastases. CONCLUSION We recommend END of levels II and III for patients with high-grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas.
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Affiliation(s)
- Marie Westergaard-Nielsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Katalin Kiss
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Tina Agander
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Tejs Ehlers Klug
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Jacobsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Jørgen Johansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | | | | | - Maria Andersen
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Kristine Bjørndal
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
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21
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Taghizadeh H, Müllauer L, Mader RM, Füreder T, Prager GW. Molecularly guided treatment of metastatic parotid gland carcinoma in adults. Wien Klin Wochenschr 2020; 133:32-40. [PMID: 33296026 PMCID: PMC7840637 DOI: 10.1007/s00508-020-01778-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 11/16/2020] [Indexed: 12/26/2022]
Abstract
Background Advanced therapy-refractory parotid gland carcinomas have a poor prognosis with limited therapy options. We used molecular profiling to offer molecular guided therapies to patients with advanced metastatic parotid gland malignancies. Methods In this retrospective analysis we describe the molecular profiling of ten patients diagnosed with therapy-refractory metastatic parotid gland malignancies. Results We identified seven genetic aberrations in five patients: two mutations in CDKN2A and one mutation in APC, ATM, TP53, SMARCB1 and FGFR1, respectively. No mutations were detected in five patients. The IHC demonstrated frequent expressions of EGFR and p‑mTOR, as well as PTEN in eight patients. For four fifths (n = 8) of the patients, a targeted therapy was suggested. Eventually, three patients received the targeted therapy recommendation and one patient achieved stable disease for 14 months. Conclusion A total of eight therapy recommendations were provided. Based on our observations, molecular-guided therapies may be a feasible treatment approach for this rare disease entity.
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Affiliation(s)
- Hossein Taghizadeh
- Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.,Comprehensive Cancer Center Vienna, Vienna, Austria
| | - Leonhard Müllauer
- Clinical Institute of Pathology, Medical University Vienna, Vienna, Austria
| | - Robert M Mader
- Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Thorsten Füreder
- Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.,Comprehensive Cancer Center Vienna, Vienna, Austria
| | - Gerald W Prager
- Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. .,Comprehensive Cancer Center Vienna, Vienna, Austria.
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22
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Sideris A, Rao A, Maher N, Parker A, Crawford J, Smee R, Jacobson I, Gallagher R. Acinic cell carcinoma of the salivary gland in the adult and paediatric population: a survival analysis. ANZ J Surg 2020; 91:1233-1239. [PMID: 33205582 DOI: 10.1111/ans.16421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/14/2020] [Accepted: 10/23/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acinic cell carcinoma (AcCC) is a rare malignant neoplasm of the salivary glands and generally considered to be a low-grade tumour. Surgical treatment is often curative, but a more aggressive high-grade variant has been associated with poorer survival and propensity for distant metastasis. No standard treatment guidelines exist and the approach to treatment is varied in the published series. The aim of this study is to present the experience of three major hospitals in Sydney, Australia, in treating AcCC of the salivary gland, with a focus on clinico-pathological features of disease and their associations with survival outcomes. METHODS Adult and paediatric cases of AcCC of the salivary gland during the time period 1979-2018 were retrospectively included. Demographic, clinico-pathological, treatment and survival outcome data were extracted. Survival analysis was undertaken to assess the effect of clinical and pathological variables on overall and disease-free survival. RESULTS Thirty-two cases were reviewed (29 adult and three paediatric). Thirty tumours (93.8%) were parotid gland primary tumours. Mean overall and disease-free survival was 17.0 ± 0.7 and 16.0 ± 0.9 years, respectively. Features associated with poorer survival were cT staging >1, presence of preoperative clinical facial nerve deficit and local recurrence. Positive margins were associated with recurrence. CONCLUSION These data suggest that disease-free and overall survival in AcCC of the salivary gland is excellent with surgery as the first-line treatment. Poor survival outcomes are uncommon and may be associated with locally advanced disease in the presence of other well-established high-risk features.
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Affiliation(s)
- Anders Sideris
- Department of Otolaryngology/Head and Neck Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.,ORL Head and Neck Research Group, Prince of Wales Hospital, Sydney, New South Wales, Australia.,Department of ENT/Head and Neck Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Amshuman Rao
- Department of Otolaryngology/Head and Neck Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Nigel Maher
- SydPath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Andrew Parker
- SydPath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Julia Crawford
- Department of Otolaryngology/Head and Neck Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Robert Smee
- Department of Radiation Oncology, Tamworth Hospital, Tamworth, New South Wales, Australia.,Department of Radiation Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Ian Jacobson
- Department of ENT/Head and Neck Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia.,Department of ENT/Head and Neck Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Richard Gallagher
- Department of Otolaryngology/Head and Neck Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia
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23
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Guntinas-Lichius O, Thielker J, Robbins KT, Olsen KD, Shaha AR, Mäkitie AA, de Bree R, Vander Poorten V, Quer M, Rinaldo A, Kowalski LP, Rodrigo JP, Hamoir M, Ferlito A. Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review. Head Neck 2020; 43:997-1008. [PMID: 33169420 DOI: 10.1002/hed.26541] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/30/2020] [Accepted: 10/30/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prognostic importance of intraparotid lymph node metastasis (P+) in patients with primary parotid gland carcinoma is unclear. METHODS Nineteen retrospective and noncomparative cohort studies, published between 1992 and 2020, met the inclusion criteria and included 2202 patients for this systematic review. RESULTS The pooled prevalence of the P in adult patients in the unselected studies was 24.10% (95% confidence interval = 17.95-30.25). The number of P+ lymph nodes per patient was counted in only three studies and ranged from 1 to 11. The 5-year recurrence-free survival rate based on Kaplan-Meier analysis varied from 83% to 88% in P- patients compared to 36% to 54% in P+ patients. The average hazard ratio for tumor recurrence in patients with P+ compared to P- was 2.67 ± 0.58. CONCLUSIONS P+ is an independent negative prognostic factor in primary parotid gland cancer and should be included into the treatment planning.
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Affiliation(s)
- Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Facial Nerve Center, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Multidisciplinary Salivary Gland Society, Geneva, Switzerland
| | - Jovanna Thielker
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Facial Nerve Center, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - K Thomas Robbins
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University, Springfield, Illinois, USA
| | - Kerry D Olsen
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vincent Vander Poorten
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven and Department of Oncology, Section Head and Neck Oncology, Leuven, Belgium
| | - Miquel Quer
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, and Division of Head and Neck Surgery, Sao Paulo State University Medical School, São Paulo, Brazil
| | - Juan Pablo Rodrigo
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Marc Hamoir
- Department of Head & Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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24
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Heidari F, Heidari F, Rahmaty B, Jafari N, Aghazadeh K, Sohrabpour S, Karimi E. The role of core needle biopsy in parotid glands lesions with inconclusive fine needle aspiration. Am J Otolaryngol 2020; 41:102718. [PMID: 32977065 DOI: 10.1016/j.amjoto.2020.102718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/07/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Usefulness of preoperative tissue sampling and pathology diagnoses in parotid gland tumors were accepted worldwide. We investigate the role of CNB in the parotid gland lesions when FNA results are inconclusive. METHODS We conducted a cross sectional study to evaluate CNB results from fifty-two patients with history of parotid gland lesion and inconclusive previous fine needle aspiration. RESULTS In this study, 45 out of 52 CNB results determined definite histological subtype diagnosis. Four CNB reports were inconclusive and three CNB results were compatible with malignancies, but did not define definite diagnosis. Calculated sensitivity for diagnosis of malignancy was 96% and specificity was 85%. Negative predictive value, positive predictive value, and accuracy for CNB in detecting malignancy, were calculated 94%, 90%, and 92%, respectively. CONCLUSIONS When FNA is not conclusive, CNB may be used as a precise method to evaluate the parotid gland lesions.
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Affiliation(s)
- Farrokh Heidari
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Firouzeh Heidari
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Benyamin Rahmaty
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Neda Jafari
- Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kayvan Aghazadeh
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Saeed Sohrabpour
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Karimi
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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25
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Pfister DG, Spencer S, Adelstein D, Adkins D, Anzai Y, Brizel DM, Bruce JY, Busse PM, Caudell JJ, Cmelak AJ, Colevas AD, Eisele DW, Fenton M, Foote RL, Galloway T, Gillison ML, Haddad RI, Hicks WL, Hitchcock YJ, Jimeno A, Leizman D, Maghami E, Mell LK, Mittal BB, Pinto HA, Ridge JA, Rocco JW, Rodriguez CP, Shah JP, Weber RS, Weinstein G, Witek M, Worden F, Yom SS, Zhen W, Burns JL, Darlow SD. Head and Neck Cancers, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:873-898. [DOI: 10.6004/jnccn.2020.0031] [Citation(s) in RCA: 313] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Treatment is complex for patients with head and neck (H&N) cancers with specific site of disease, stage, and pathologic findings guiding treatment decision-making. Treatment planning for H&N cancers involves a multidisciplinary team of experts. This article describes supportive care recommendations in the NCCN Guidelines for Head and Neck Cancers, as well as the rationale supporting a new section on imaging recommendations for patients with H&N cancers. This article also describes updates to treatment recommendations for patients with very advanced H&N cancers and salivary gland tumors, specifically systemic therapy recommendations.
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Affiliation(s)
| | | | - David Adelstein
- 3Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Douglas Adkins
- 4Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Yoshimi Anzai
- 5Huntsman Cancer Institute at the University of Utah
| | | | | | | | | | | | | | - David W. Eisele
- 12The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | - Moon Fenton
- 13The University of Tennessee Health Science Center
| | | | | | | | | | | | | | | | - Debra Leizman
- 3Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | - Bharat B. Mittal
- 22Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - James W. Rocco
- 23The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | | | | | - Sue S. Yom
- 27UCSF Helen Diller Family Comprehensive Cancer Center
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26
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Hanege FM, Tuysuz O, Sakallioglu O, Arslan Solmaz O. Diagnostic value of preoperative fine needle aspiration cytology in parotid gland tumors. Diagn Cytopathol 2020; 48:1075-1080. [PMID: 32562515 DOI: 10.1002/dc.24514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Salivary gland masses constitute a broad spectrum of lesions ranging from non-neoplastic to benign and malignant lesions. Parotid is the largest salivary gland and constitutes 75% to 80% of all salivary gland areas. 80% of parotid lesions are benign and 20% are malignant. METHODS Two-hundred and eight-six patients who underwent aspiration cytology in the pathology laboratory between January 1995 and January 2019, evaluated with a sufficient sample and diagnosed, and subsequently underwent surgical treatment were included in the study. RESULTS 47.9% (137) of the patients were female and 52.1% (149) were male. The mean age was 58 years (range: 38-84 years). 13 (4.54%) of the cases were evaluated as non-diagnostic, 12 (4.1%) as atypia of undetermined significance, 196 (68.5%) as benign neoplasm, 43 (15%) as suspicious for malignancy, and 22 (7.86%) were evaluated as malignant. In the histopathological examination of the samples prepared from surgical specimens of 13 non-diagnostic cases, seven (53.8%) cases were reported as Warthin tumors, four (30.7%) as pleomorphic adenomas, and two (15.5%) were reported as lymph nodes with intraparotid localization. CONCLUSION The diagnosis of Fine needle aspiration cytology (FNAC) in the parotid gland is difficult due to the rarity of malignant salivary gland neoplasms, the diversity of carcinoma types, and the similarity of cytologic findings of benign tumors and low-grade carcinomas. The diagnostic accuracy of preoperative FNAC is high for benign tumors and low for malignant tumors.
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Affiliation(s)
- Fatih Mehmet Hanege
- Istanbul Medeniyet University, School of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ozan Tuysuz
- Istanbul Medeniyet University, School of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Oner Sakallioglu
- Department of Otorhinolaryngology and Head & Neck Surgery, University of Health Sciences, Elazig Health Practices And Research Center, Elazig, Turkey
| | - Ozgen Arslan Solmaz
- Department of Pathology, University of Health Sciences, Elazig Health Practices And Research Center, Elazig, Turkey
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27
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Vartanian JG, Gonçalves Filho J, Kowalski LP, Shah JP, Suárez C, Rinaldo A, De Bree R, Rodrigo JP, Hamoir M, Takes RP, Mäkitie AA, Zbären P, Andreasen S, Poorten VV, Sanabria A, Hellquist H, Robbins KT, Bödeker CC, Silver C, Ferlito A. An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid gland. Expert Rev Anticancer Ther 2019; 19:899-908. [PMID: 31591950 DOI: 10.1080/14737140.2019.1674143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Management of clinically negative neck (cN0) in patients with parotid gland cancer is controversial. Treatment options can include observation, elective neck dissection or elective radiotherapy. Areas covered: We addressed the treatment options for cN0 patients with parotid gland cancer. A literature review was undertaken to determine the optimal management of this group of patients. Expert opinion: Patients with parotid carcinoma and clinically negative neck have various options for their management. The analysis of tumor stage, histology and grade is essential to better define patients at risk for occult lymph node metastasis. These patients can be managed by surgery, radiotherapy or their combination, depending on the presence of risk factors, the moment at which such risk factors are detected, patient-related clinical conditions, medical provider expertise and institutional facilities.
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Affiliation(s)
- Jose Guilherme Vartanian
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center , Sao Paulo , Brazil
| | - Joao Gonçalves Filho
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center , Sao Paulo , Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center , Sao Paulo , Brazil
| | - Jatin P Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo , Oviedo , Spain.,Servicio de Otorrinolaringología, Instituto de Investigación Sanitaria del Principado de Asturias , Oviedo , Spain
| | | | - Remco De Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht , Utrecht , The Netherlands
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto de Oncología de Asturias, University of Oviedo, Centro de Investigación Biomédica en Red de Cáncer , Oviedo , Spain
| | - Marc Hamoir
- Department of Head & Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain , Brussels , Belgium
| | - Robert P Takes
- Department of Otorhinolaryngology - Head and Neck Surgery, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Antti A Mäkitie
- Faculty of Medicine, University of Helsinki, Research Programme in Systems Oncology , Helsinki , Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital , Stockholm , Sweden.,Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Peter Zbären
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital , Berne , Switzerland
| | - Simon Andreasen
- Department of Otolaryngology Head & Neck Surgery and Audiology and Department of Pathology Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.,Department of Otolaryngology and Maxillofacial Surgery, Zealand University Hospital , Køge , Denmark
| | - Vincent Vander Poorten
- Multidisciplinary Salivary Gland Society , Geneva , Switzerland.,Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, section Head and Neck Oncology, University Hospitals Leuven , Leuven , Belgium
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Clinica Vida, Universidad de Antioquia , Medellín , Colombia
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, University of Algarve , Faro , Portugal
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine , Springfield , USA
| | - Carsten C Bödeker
- Department of Otorhinolaryngology-Head and Neck Surgery, HELIOS Hanseklinikum , Stralsund , Germany
| | - Carl Silver
- Department of Surgery, University of Arizona College of Medicine , Phoenix , AZ , USA
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group , Padua , Italy
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28
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Grasl S, Janik S, Grasl MC, Pammer J, Formanek M, Weinreb I, Perez-Ordonez B, Hope A, Hosni A, de Almeida JR, Irish J, Gilbert R, Goldstein DP, Erovic BM. Nodal Metastases in Acinic Cell Carcinoma of the Parotid Gland. J Clin Med 2019; 8:jcm8091315. [PMID: 31461946 PMCID: PMC6780641 DOI: 10.3390/jcm8091315] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/20/2022] Open
Abstract
The objective of this study was to evaluate the clinical outcome of patients with acinic cell carcinomas of the parotid gland after elective neck dissection (END). A retrospective chart review was performed including 66 patients with acinic cell carcinoma of the parotid gland. Clinical parameters were retrieved and statistically analyzed regarding disease-free survival (DFS) and disease-specific survival (DSS). An END was done in 27 (40.9%) patients, and occult metastases were detected in 4 (14.8%) patients of whom three were low-grade carcinoma. Positive neck nodes were associated with significantly worse DSS (p = 0.05). Intermediate and high-grade carcinoma (HR 8.62; 95% confidence interval (CI): 1.69-44.01; p = 0.010), perineural invasion (HR 19.6; 95%CI: 0.01-0.37; p = 0.003) and lymphovascular invasion (HR 10.2; 95%CI: 0.02-0.59; p = 0.011) were worse prognostic factors for DFS. An END should be considered in patients with acinic cell carcinoma of the parotid gland due to (i) a notable rate of occult neck metastases in low-grade tumors and (ii) the worse DSS of patients with positive neck nodes.
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Affiliation(s)
- Stefan Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Matthaeus C Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes Pammer
- Clinical Institute of Pathology, Medical University of Vienna, A-1097 Vienna, Austria
| | - Michael Formanek
- Department of Otorhinolaryngology and Phonetics, Hospital of St. John of God, 1020 Vienna, Austria
- Sigmund Freud University, Medical School, 1020 Vienna, Austria
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada
| | - Bayardo Perez-Ordonez
- Department of Pathology, University Health Network, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada
| | - Andrew Hope
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, ON M5G2C4, Canada
| | - Jon Irish
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, ON M5G2C4, Canada
| | - Ralph Gilbert
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, ON M5G2C4, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, ON M5G2C4, Canada.
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, 1180 Vienna, Austria.
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29
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Scherl C, Haderlein M, Agaimy A, Mantsopoulos K, Koch M, Traxdorf M, Fietkau R, Grundtner P, Iro H. Outcome and management of rare high-grade “salivary” adenocarcinoma: the important role of adjuvant (chemo)radiotherapy. Strahlenther Onkol 2019; 195:1050-1059. [DOI: 10.1007/s00066-019-01499-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/10/2019] [Indexed: 01/17/2023]
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30
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Mantsopoulos K, Mueller S, Goncalves M, Koch M, Iro H. Completion surgery after extracapsular dissection of low-grade parotid gland malignant tumors. Head Neck 2019; 41:3383-3388. [PMID: 31273890 DOI: 10.1002/hed.25863] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/09/2019] [Accepted: 06/18/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The aim of the study was to compare the oncological and functional outcome between extracapsular dissection and completion surgery on the one hand and sole extracapsular dissection on the other hand in small low-grade malignant parotid tumors. METHODS The records of all patients treated for T1-T2 low-grade malignant tumors of the parotid gland primarily by means of extracapsular dissection between 2006 and 2015 were studied retrospectively. RESULTS Forty patients with T1-T2 low-grade parotid malignancies were detected. Our study showed outstanding oncological outcomes in both patient groups, the facial nerve function being significantly better after sole extracapsular dissection in the direct postoperative phase, with no differences between the groups in the long term. CONCLUSIONS Our study showed very encouraging preliminary results following primary extracapsular dissection as the sole surgical therapy for carefully selected low-stage, low-grade, inferiorly located lesions in patients with high compliance.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sarina Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Miguel Goncalves
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Koch
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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31
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Brown AL, Al-Samadi A, Sperandio M, Soares AB, Teixeira LN, Martinez EF, Demasi APD, Araújo VC, Leivo I, Salo T, Passador-Santos F. MiR-455-3p, miR-150 and miR-375 are aberrantly expressed in salivary gland adenoid cystic carcinoma and polymorphous adenocarcinoma. J Oral Pathol Med 2019; 48:840-845. [PMID: 31165496 DOI: 10.1111/jop.12894] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Adenoid cystic carcinoma (AdCC) and polymorphous adenocarcinoma (PAC) are included among the most common salivary gland cancers. They share clinical and histological characteristics, making their diagnosis challenging in specific cases. MicroRNAs (miRNA) are short, non-coding RNA sequences of 19-25 nucleotides in length that are involved in post-transcriptional protein expression. They have been shown to play important roles in neoplastic and non-neoplastic processes and have been suggested as diagnostic and prognostic markers. METHODS This study, using quantitative RT-PCR, investigated miR-150, miR-455-3p and miR-375 expression, in order to identify a possible molecular distinction between AdCC and PAC. RESULTS miRNA-150 and miRNA-375 expression was significantly decreased in AdCC and PAC compared with salivary gland tissue controls, whilst miRNA-455-3p showed significantly increased expression in AdCC when compared to PAC, (P < 0.05). miR-150, miR-357 and miR-455-3p expression in AdCC, PAC and control was not associated with age, gender nor with anatomic site (major and minor salivary glands) (P > 0.05). CONCLUSION MiR-455-3p could be used as a complimentary tool in the diagnosis of challenging AdCC cases.
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Affiliation(s)
- Amy L Brown
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marcelo Sperandio
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Andresa Borges Soares
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Lucas Novaes Teixeira
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Elizabeth F Martinez
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Ana Paula Dias Demasi
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Vera Cavalcanti Araújo
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Ilmo Leivo
- Institute of Biomedicine, Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Medical Research Centre, Oulu University Hospital, Oulu, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Fabricio Passador-Santos
- Department of Oral Pathology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
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32
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Qian K, Guo K, Zheng X, Sun W, Sun T, Chen L, Ma D, Wu Y, Ji Q, Wang Z. The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma. J Craniomaxillofac Surg 2018; 47:47-52. [PMID: 30528947 DOI: 10.1016/j.jcms.2018.09.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 08/20/2018] [Accepted: 09/10/2018] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To evaluate whether elective neck dissection (END) was beneficial for cN0 patients with salivary gland carcinoma. MATERIALS AND METHODS The rates of regional failure-free survival and disease-free survival were calculated using Kaplan-Meier methods and Cox models. The risk factors for occult lymph node metastasis (OLNM) in cN0 patients undergoing END was analyzed using logistic regression. A nomogram was formulated to calculate the estimated probability of OLNM. RESULTS Neck dissection was performed in 84 patients (43.3%). OLNM was detected in eight of the patients who underwent END. During the follow-up period, regional recurrences involving cervical lymph nodes were found in 10 patients. Cox model analysis revealed that neck dissection was not related to regional failure-free survival and disease-free survival. Logistic regression analysis revealed that older age, neural symptoms, and positive adjacent lymph nodes were associated with OLNM. A nomogram comprising age, neural symptoms, and adjacent lymph nodes was developed to predict the risk of OLNM. CONCLUSION The incidence of OLNM was low in cN0 patients after detailed preoperative evaluations. There was no strong evidence supporting END as a conventional therapy in cN0 patients with salivary cancers. Our nomogram is a simple and practical instrument for strengthening the prediction of OLNM.
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Affiliation(s)
- Kai Qian
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Kai Guo
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiaoke Zheng
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wenyu Sun
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Tuanqi Sun
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Lili Chen
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ding Ma
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yi Wu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qinghai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhuoying Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Zbären P, Triantafyllou A, Devaney KO, Poorten VV, Hellquist H, Rinaldo A, Ferlito A. Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy? Eur Arch Otorhinolaryngol 2018; 275:2609-2613. [DOI: 10.1007/s00405-018-5131-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/11/2018] [Indexed: 12/17/2022]
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Abstract
PURPOSE OF REVIEW The review puts new information on geno- and phenotype of salivary duct carcinoma (SDC) in the perspective of the updated 2017 WHO classification. RECENT FINDINGS The proportion of SDC is increasing. This may be because of a true rise in incidence, but certainly to better diagnostic tests and changed WHO definitions. In this light, a substantial proportion of carcinoma expleomorphic adenoma is now attributed to the category of SDC. 'Low-grade SDC' and 'SDC in-situ' of the former WHO classification, are now named low-grade and high-grade intraductal carcinoma (IDC), respectively. Recent series quantify biologic aggressiveness: perineural growth, vascular invasion, and extracapsular extension in lymph node metastasis are each observed in two out of three patients with SDC. Most patients die within 3 years, but once 5-year disease-free survival is reached, further disease activity is exceptional. The typical molecular biological profile with high human epidermal growth factor receptor 2 and androgen receptor expression is increasingly successfully exploited in clinical trials for advanced SDC. SUMMARY The aggressive SDC is increasingly diagnosed. Despite intensive combined surgery and radiation therapy, many patients recur, for whom new bullets, targeting the molecular biological mechanisms, are the subject of ongoing clinical trials.
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Scherl C, Kato MG, Erkul E, Graboyes EM, Nguyen SA, Chi AC, Morgan PF, Day TA. Outcomes and prognostic factors for parotid acinic cell Carcinoma: A National Cancer Database study of 2362 cases. Oral Oncol 2018; 82:53-60. [PMID: 29909902 DOI: 10.1016/j.oraloncology.2018.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/04/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the demographics, clinical features, survival outcomes, and prognostic indicators of patients with acinic cell carcinoma (ACC) of the parotid gland with emphasis on the roles of grade, tumor size, and nodal status in survival. MATERIALS AND METHODS A retrospective analysis of cases diagnosed between 2004 and 2012 from the National Cancer Database was performed. Multivariable logistic regression was used to determine factors associated with survival. RESULTS 2362 cases were identified. Most patients were females (61.3%) and Caucasian (85.4%) with a median age of 54 years (range, 18-90 years). Most tumors were <3 cm in size (75.8%). Regional metastases and high-grade histology were rare (8.2%, 5.1%). All patients received surgery as primary treatment with 42.7% of patients receiving adjuvant radiation therapy or chemoradiotherapy. 5 year overall survival was 88.6%. On multivariable analysis, age >70 years (hazard ratio [HR]: 10.05, 95% confidence interval [CI]: 5.64-17.91), high-grade (HR: 5.30, 95% CI: 3.39-8.29), tumor size of 3 to 6 cm (HR: 1.53, 95% CI: 1.10-2.12), tumor size >6 cm (HR: 2.98, 95% CI: 1.681-5.289), pN2+ (HR: 3.14, 95% CI: 2.10-4.69), T4 (HR: 2.89, 95% CI: 1.74-4.80) were significant prognosticators. CONCLUSION Although patients with ACC generally are considered to have a favorable prognosis, an aggressive subgroup with poor outcomes was identified. This group is characterized by high-grade, advanced T classification, tumors larger than 3 cm, with regional metastases and age greater than 70 years. Histologic grade is a substantially stronger predictor of survival than T and N classifications.
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Affiliation(s)
- Claudia Scherl
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA.
| | - Masanari G Kato
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Evren Erkul
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Angela C Chi
- College of Dental Medicine, Medical University of South Carolina, 29 Bee Street, Charleston, SC 29425, USA
| | - Patrick F Morgan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
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36
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Wang X, Luo Y, Li M, Yan H, Sun M, Fan T. Management of salivary gland carcinomas - a review. Oncotarget 2018; 8:3946-3956. [PMID: 27992367 PMCID: PMC5354805 DOI: 10.18632/oncotarget.13952] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 12/08/2016] [Indexed: 11/29/2022] Open
Abstract
Salivary gland carcinomas are a heterogeneous group of tumors with many histological subtypes which occur in both major and minor salivary glands. However, they have a relatively low of incidence. Their rarity limits study size and the ability to perform phase III trials. Therefore, to date, the entire management is usually varied. Certain published studies have paid more attention to the systemic therapy in the management of metastatic or locally recurrent salivary gland cancer, while little effort has been made to study the entire management for this lesions. Although results of treatment for patients with salivary gland carcinoma have improved in recent years, the treatment of salivary gland cancers is still not standardized. And some patients who haven’t received optimal treatment strategies had a reduced survival. In this review, the topics covered include surgery and radiotherapy, selective neck dissection, chemotherapy, and targeted therapy, which aimed to summarize the optimal management approaches and to develop recommendations for managing this lesions. For these rare cancers, there is also a need for a determined, coordinated effort to conduct high-quality clinical trials.
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Affiliation(s)
- Xiaoli Wang
- School of Medical and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Yijun Luo
- School of Medical and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Hongjiang Yan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Mingping Sun
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Tingyong Fan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
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König L, Hauswald H, Flechtenmacher C, Heller M, Debus J, Haberkorn U, Kratochwil C, Giesel F. Uptake of Prostate-Specific Membrane Antigen (PSMA) in adenoid cystic carcinoma - Is PSMA-PET-CT a helpful tool in radiation oncology? Clin Transl Radiat Oncol 2017; 7:79-82. [PMID: 29594233 PMCID: PMC5862661 DOI: 10.1016/j.ctro.2017.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/02/2017] [Accepted: 10/07/2017] [Indexed: 10/29/2022] Open
Abstract
This case report shows the high PSMA-uptake in a patient with an adenoid cystic carcinoma of the maxillary sinus. Due to the intense ligand-uptake additional information for target volume delineation was obtained and the Treatment plan for bimodal radiotherapy with carbon ions was adapted accordingly.
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Key Words
- ACC, Adenoid cystic carcinoma
- CTCAE, Common terminology criteria of adverse events
- HIT, Heidelberg Ion Beam Therapy Center
- IHC, Immunohistochemistry
- IMRT, intensity modulated radiotherapy
- PET-CT, Positron emission tomography-computed tomography
- PSMA, Prostate-Specific Membrane Antigen
- RBE, Relative Biological Effectiveness
- RECIST, Response Evaluation Criteria In Solid Tumors
- RT, radiotherapy
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Affiliation(s)
- Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Henrik Hauswald
- Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Christa Flechtenmacher
- Institute of Pathology, Heidelberg University Hospital, INF 224, 69120 Heidelberg, Germany
| | - Martina Heller
- Section of Molecular Urooncology, Department of Urology, Heidelberg University Hospital, INF 517, 69120 Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany
| | - Clemens Kratochwil
- Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany
| | - Frederik Giesel
- Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany
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38
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Mifsud MJ, Burton JN, Trotti AM, Padhya TA. Multidisciplinary Management of Salivary Gland Cancers. Cancer Control 2017; 23:242-8. [PMID: 27556664 DOI: 10.1177/107327481602300307] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Salivary carcinomas are a rare group of biologically diverse neoplasms affecting the head and neck. The wide array of different histological entities and clinical presentations has historically limited attempts to establish well-defined treatment algorithms. In general, low-risk lesions can be managed with a single treatment modality, whereas advanced lesions require a more complex, multidisciplinary approach. METHODS The relevant literature was reviewed, focusing on diagnostic and treatment algorithms for salivary malignancies. RESULTS Salivary carcinomas with high-risk features require an aggressive treatment approach with complete surgical resection, neck dissection to appropriate cervical lymph-node basins, and postoperative radiotherapy. CONCLUSIONS The heterogeneity of salivary neoplasms represents a unique clinical challenge. Despite the multidisciplinary management paradigm detailed in this review, outcomes for advanced disease are unsatisfactory. Future progress will likely require the addition of novel systemic therapeutic strategies.
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Affiliation(s)
- Matthew J Mifsud
- Department of Otolaryngology-Head & Neck Surgery, Mount Sinai Hospital, Toronto, ON M5G1X5, Canada.
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39
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Lewis AG, Tong T, Maghami E. Diagnosis and Management of Malignant Salivary Gland Tumors of the Parotid Gland. Otolaryngol Clin North Am 2017; 49:343-80. [PMID: 27040585 DOI: 10.1016/j.otc.2015.11.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Malignant parotid tumors are heterogeneous and diverse. Accurate diagnosis requires a pathologist familiar with the various histologic subtypes, immunohistochemistry stains, and common translocations. Clinical course varies according to tumor subtype, ranging from indolent, slow-growing adenoid cystic carcinoma to rapidly progressive, possibly fatal, salivary ductal carcinoma. Histologic grade is important in prognosis and therapy. Surgery remains the mainstay of treatment when negative margins can be achieved. Radiation improves locoregional control of tumors with high-risk features. Chemotherapy for parotid tumors can be disappointing. Studies of new targeted therapies have not offered significant benefits.
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Affiliation(s)
- Aaron G Lewis
- Department of Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Tommy Tong
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Ellie Maghami
- Division of Head and Neck Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
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40
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Lombardi D, McGurk M, Vander Poorten V, Guzzo M, Accorona R, Rampinelli V, Nicolai P. Surgical treatment of salivary malignant tumors. Oral Oncol 2016; 65:102-113. [PMID: 28017651 DOI: 10.1016/j.oraloncology.2016.12.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/16/2016] [Accepted: 12/09/2016] [Indexed: 12/14/2022]
Abstract
Salivary gland malignant tumors (SGMT) are of key interest for head and neck surgeons since surgery with adjuvant radiotherapy is considered the treatment of choice in most of the cases. Some factors, namely rarity, high histologic heterogeneity, and possible occurrence in all the head and neck subsites, contribute to make this topic very controversial; some unclear aspects pertain surgical treatment. When dealing with major salivary gland malignant tumors (MaSGMT), the most debated issues remain the extent of surgery and management of facial nerve. In minor salivary gland malignant tumors (MiSGMT), conversely, surgical planning is influenced by the specific pattern of growth of the different neoplasms as well as the site of origin of the lesion. Finally, two additional issues, the treatment of the neck (therapeutic or elective) and reconstructive strategy after ablative surgery, are of pivotal importance in management of both MaSGMT and MiSGMT. In this review, we discuss the most relevant and controversial issues concerning surgery of SGMT.
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Affiliation(s)
- Davide Lombardi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy.
| | - Marc McGurk
- Guys and St. Thomas NHS Trust, London, United Kingdom
| | - Vincent Vander Poorten
- Otorhinolaryngology - Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; European Salivary Gland Society, Geneva, Switzerland
| | - Marco Guzzo
- Department of Head and Neck Surgery, Istituto Nazionale dei Tumori, Milan, Italy
| | - Remo Accorona
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy
| | - Vittorio Rampinelli
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Italy
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41
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Becker C, Dahlem KKK, Pfeiffer J. Prognostic value of comorbidities in patients with carcinoma of the major salivary glands. Eur Arch Otorhinolaryngol 2016; 274:1651-1657. [DOI: 10.1007/s00405-016-4404-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 11/23/2016] [Indexed: 12/16/2022]
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42
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Green B, Rahimi S, Brennan PA. Salivary gland malignancies - an update on current management for oral healthcare practitioners. Oral Dis 2016; 22:735-739. [DOI: 10.1111/odi.12498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/01/2022]
Affiliation(s)
- B Green
- Department of Gastroenterology; Torbay Hospital; Torquay UK
| | - S Rahimi
- Department of Histopathology; Queen Alexandra Hospital; Portsmouth UK
| | - PA Brennan
- Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
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43
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Meyer M, Kreppel M, Meinrath J, Grünewald I, Stenner M, Drebber U, Quaas A, Odenthal M, Semrau R, Huebbers C, Zöller J, Huettenbrink KB, Buettner R, Beutner D. Prediction of outcome by lymph node ratio in patients with parotid gland cancer. Clin Otolaryngol 2016; 42:98-103. [DOI: 10.1111/coa.12672] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 12/17/2022]
Affiliation(s)
- M.F. Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Cologne; Cologne Germany
| | - M. Kreppel
- Department for Oral and Maxillofacial Plastic Surgery; University of Cologne; Cologne Germany
| | - J. Meinrath
- Department of Pathology; University of Cologne; Cologne Germany
| | - I. Grünewald
- Department of Pathology; University of Cologne; Cologne Germany
| | - M. Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Cologne; Cologne Germany
| | - U. Drebber
- Department of Pathology; University of Cologne; Cologne Germany
| | - A. Quaas
- Department of Pathology; University of Cologne; Cologne Germany
| | - M. Odenthal
- Department of Pathology; University of Cologne; Cologne Germany
| | - R. Semrau
- Department of Radiation Oncology; University of Cologne; Cologne Germany
| | - C.U. Huebbers
- Jean-Uhrmacher Institute; University of Cologne; Cologne Germany
| | - J. Zöller
- Department for Oral and Maxillofacial Plastic Surgery; University of Cologne; Cologne Germany
| | - K-B. Huettenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Cologne; Cologne Germany
| | - R. Buettner
- Department of Pathology; University of Cologne; Cologne Germany
| | - D. Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Cologne; Cologne Germany
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44
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Green B, Rahimi S, Brennan PA. Current management of the neck in salivary gland carcinomas. J Oral Pathol Med 2016; 46:161-166. [DOI: 10.1111/jop.12458] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2016] [Indexed: 01/12/2023]
Affiliation(s)
- Ben Green
- Department of Gastroenterology; Torbay Hospital; Torquay UK
| | - Siavash Rahimi
- Department of Histopathology; Queen Alexandra Hospital; Portsmouth UK
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45
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Mifsud MJ, Tanvetyanon T, Mccaffrey JC, Otto KJ, Padhya TA, Kish J, Trotti AM, Harrison LB, Caudell JJ. Adjuvant radiotherapy versus concurrent chemoradiotherapy for the management of high-risk salivary gland carcinomas. Head Neck 2016; 38:1628-1633. [PMID: 27098984 DOI: 10.1002/hed.24484] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/31/2016] [Accepted: 03/16/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Given the aggressive behavior of advanced salivary malignancies, the purpose of the current study was to explore the utility of adjuvant chemoradiotherapy (CRT) in this population. METHODS A retrospective study of salivary carcinomas treated from 1998 to 2013 with postoperative CRT (37 patients) or radiotherapy (RT; 103 patients) was completed. RESULTS The decision to utilize adjuvant CRT versus RT was influenced by tumor grade and histology, cervical lymph node status, surgical margins, and perineural invasion. In both treatment cohorts, high locoregional control rates were obtained (79% for CRT vs 91% for RT; p = .031). Multivariate Cox regression analysis did not identify a difference in 3-year progression-free survival (PFS) with the use of CRT versus RT (hazard ratio [HR] = 0.783; 95% confidence interval [CI] = 0.396-1.549; p = .482). CONCLUSION Until prospective evidence is available, such as from Radiation Therapy Oncology Group 1008, the standard use of CRT for advanced salivary malignancies cannot be recommended. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
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Affiliation(s)
- Matthew J Mifsud
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Tawee Tanvetyanon
- Department of Thoracic Oncology and Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Judith C Mccaffrey
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kristen J Otto
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Tapan A Padhya
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Julie Kish
- Department of Senior Adult Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Andy M Trotti
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Louis B Harrison
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Jimmy J Caudell
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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46
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Das S, Nayak UK, Buggavetti R, Sekhar S. Adenoid Cystic Carcinoma of Accessory Parotid Gland: A Case Report. J Oral Maxillofac Surg 2016; 74:1097.e1-5. [PMID: 26851989 DOI: 10.1016/j.joms.2016.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/05/2016] [Accepted: 01/05/2016] [Indexed: 11/16/2022]
Abstract
The accessory parotid gland is salivary gland tissue separated from the main gland at a variable distance. This gland is histologically similar to the main gland, but has a higher incidence of malignant neoplasms than the main gland. Regarding the various malignant neoplasms, studies have shown higher incidences of mucoepidermoid carcinoma, with less than 2% being adenoid cystic carcinoma. We present a case of swelling in the midcheek region that, after clinical examination, was diagnosed as a case of neoplasm of the accessory parotid gland. On the basis of auxiliary investigations including intraoperative frozen section, it was concluded that it was adenoid cystic carcinoma, grade I, and after wide surgical resection, the tumor was removed without undergoing superficial parotidectomy. The patient received postoperative radiotherapy (RT) and was followed for 14 months without any recurrence or substantial facial asymmetry.
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Affiliation(s)
- Somdipto Das
- Fellow, Department of Head and Neck Surgical Oncology, Apollo Cancer Hospital, Hyderabad, India.
| | - Umanath K Nayak
- Fellow (AHNS) and Department Head, Department of Head and Neck Surgical Oncology, Apollo Cancer Hospital, Hyderabad, India
| | - Rahul Buggavetti
- Consultant, Department of Head and Neck Surgical Oncology, Apollo Cancer Hospital, Hyderabad, India
| | - Shobana Sekhar
- Registrar, Department of Head and Neck Surgical Oncology, Apollo Cancer Hospital, Hyderabad, India
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47
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Chmieliauskaite M, Sollecito TP, Stoopler ET. Emergency route diagnosis of mucoepidermoid carcinoma initially diagnosed as a temporomandibular disorder. SPECIAL CARE IN DENTISTRY 2016; 36:39-42. [PMID: 26782364 DOI: 10.1111/scd.12142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Salivary gland malignancy (SGM) can affect both major and minor glands and manifests clinically with various presentations. The most common type of SGM is mucoepidermoid carcinoma (MEC), which has been previously reported to be associated with symptomatology associated with temporomandibular disorders (TMD). This case report describes a patient with an aggressive form of MEC of the parotid gland that was initially diagnosed as TMD. In addition, the patient's MEC was diagnosed emergently based on development of acute clinical symptomatology. To the best of our knowledge, emergency route diagnosis of MEC affecting the parotid gland has not been previously reported in the literature.
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Affiliation(s)
- Milda Chmieliauskaite
- Chief Resident, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Thomas P Sollecito
- Chair and Professor of Oral Medicine, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Eric T Stoopler
- Associate Professor of Oral Medicine, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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48
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Otsuka K, Imanishi Y, Tada Y, Kawakita D, Kano S, Tsukahara K, Shimizu A, Ozawa H, Okami K, Sakai A, Sato Y, Ueki Y, Sato Y, Hanazawa T, Chazono H, Ogawa K, Nagao T. Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients. Ann Surg Oncol 2016; 23:2038-45. [PMID: 26790669 PMCID: PMC4858547 DOI: 10.1245/s10434-015-5082-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Among salivary gland malignancies, the prognosis of salivary duct carcinoma (SDC) is assumed to be the poorest. However, because of its low incidence, reliable survival estimates and prognostic factors based on a large number of patients remain to be elucidated, thereby making it impossible to standardize the optimal treatment for SDC. METHODS We performed this multi-institutional, retrospective analysis by collecting the clinical information of 141 patients with SDC without distant metastasis who underwent curative surgery as the initial treatment to elucidate overall survival (OS) and disease-free survival (DFS) along with their prognostic factors. RESULTS The 3-year OS and DFS rates were 70.5 and 38.2 %, respectively. Multivariate analysis revealed that age ≥65 years (p < 0.001) and N1 and N2 (p = 0.047 and <0.001, respectively) were independent prognostic factors for OS, whereas the primary site of the minor salivary and sublingual gland (p < 0.001) and N2 (p < 0.001) were those for DFS. The most common treatment failure was distant metastasis (55 patients, 39.0 %). For early parotid SDC, neither total parotidectomy in the patients with early T stage nor nerve resection in the patients without facial nerve palsy showed survival benefits. CONCLUSIONS Advanced N stage independently affects both OS and DFS. Partial parotidectomy with facial nerve preservation could be a less invasive standard surgical procedure for parotid gland SDC in the early T stage without facial nerve palsy. Effective systemic therapy is imperative to improve DFS of SDC.
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Affiliation(s)
- Kuninori Otsuka
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Otorhinolaryngology, Saiseikai Yokohama Tobu Hospital, Yokohama, Japan
| | - Yorihisa Imanishi
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Daisuke Kawakita
- Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kiyoaki Tsukahara
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Akira Shimizu
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Akihiro Sakai
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yushi Ueki
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yukiko Sato
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideaki Chazono
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kaoru Ogawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan
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49
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Which is the most suitable lymph node predictor for overall survival after primary surgery of head and neck cancer: pN, the number or the ratio of positive lymph nodes, or log odds? J Cancer Res Clin Oncol 2015; 142:885-93. [PMID: 26711282 DOI: 10.1007/s00432-015-2104-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/18/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate the best lymph node (LN) metastasis predictor for overall survival (OS) in head neck cancer (HNC): pN classification, number of positive lymph nodes (PNOD), lymph node ratio (LNR), or log odds of positive lymph nodes (LODDS). METHODS In total, 225 surgically treated HNC patients were evaluated for the different LN classifications and OS. RESULTS Five-year OS was 71.8 %. Mean number of yielded LN and PNOD was 25.3 ± 16.7 and 2.7 ± 5.9, respectively. 64.8 % had a LNR > 0.10 and 64.4 % a LODDS > 10. In univariable analysis, multimodal therapy (p = 0.039), advanced pT (p < 0.0001), advanced UICC stage (p = 0.029), LNR > 0.10 (p = 0.049), and LODDS > -1.0 (p = 0.021) were associated with lower OS. In multivariable analysis, advanced pT [hazard ratio (HR) 2.194; 95 % confidence interval (CI) 1.294-3.722; p = 0.004] and LODDS > -1.0 (HR 1.634; 95 % CI 1.002-2.665; p = 0.059) remained independent predictors for lower OS. CONCLUSIONS It seems useful to analyze the prognostic significance of LODDS in other samples of HNC.
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50
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Vander Poorten V, Triantafyllou A, Thompson LDR, Bishop J, Hauben E, Hunt J, Skalova A, Stenman G, Takes RP, Gnepp DR, Hellquist H, Wenig B, Bell D, Rinaldo A, Ferlito A. Salivary acinic cell carcinoma: reappraisal and update. Eur Arch Otorhinolaryngol 2015; 273:3511-3531. [PMID: 26685679 DOI: 10.1007/s00405-015-3855-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 12/07/2015] [Indexed: 01/10/2023]
Abstract
Epidemiologic and clinicopathologic features, therapeutic strategies, and prognosis for acinic cell carcinoma of the major and minor salivary glands are critically reviewed. We explore histopathologic, histochemical, electron microscopic and immunohistochemical aspects and discuss histologic grading, histogenesis, animal models, and genetic events. In the context of possible diagnostic difficulties, the relationship to mammary analog secretory carcinoma is probed and a classification is suggested. Areas of controversy or uncertainty, which may benefit from further investigations, are also highlighted.
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Affiliation(s)
- V Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, Department of Oncology-Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium. .,European Salivary Gland Society, Geneva, Switzerland.
| | - A Triantafyllou
- School of Dentistry, University of Liverpool, Liverpool, UK.,Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - L D R Thompson
- Southern California Permanente Medical Group, Woodland Hills, CA, USA
| | - J Bishop
- Department of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E Hauben
- Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - J Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles, University Prague, Prague, Czech Republic
| | - G Stenman
- European Salivary Gland Society, Geneva, Switzerland.,Department of Pathology, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - R P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D R Gnepp
- University Pathologists, Fall River, MA, USA
| | - H Hellquist
- Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - B Wenig
- Department of Pathology, Beth Israel Medical Center, New York, NY, USA
| | - D Bell
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - A Rinaldo
- University of Udine School of Medicine, Udine, Italy
| | - A Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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