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Patil R, Uzzaman L, Kelly C, Kovarik J, Jackson M, Paterson C, Munro SP, Wilson A, Iqbal MS. Role of Adjuvant Radiotherapy in Acinic Cell Carcinoma of the Salivary Glands: A Systematic Review. Clin Oncol (R Coll Radiol) 2023; 35:e489-e497. [PMID: 37355414 DOI: 10.1016/j.clon.2023.06.011] [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: 02/14/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
A systematic review was carried out to evaluate if adjuvant radiotherapy for acinic cell carcinomas (ACCs) of salivary glands improves survival. Twelve retrospective studies published between 2000 and 2020 that analysed the effect of radiotherapy on salivary gland neoplasms and ACCs of salivary glands and met the inclusion criteria were included in the review. The overall quality of the studies was moderate to low. There was no high-quality evidence for improved survival with radiotherapy for ACCs of the salivary gland. Some evidence suggests that there may be an advantage for patients with high-grade tumours, but these data should be interpreted with caution due to the small number of patients and low-quality evidence. Good quality of evidence is lacking. Recommendation for adjuvant radiotherapy for tumours with poor prognostic factors will require discussion and shared decision-making with the patients.
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Affiliation(s)
- R Patil
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - L Uzzaman
- Department of Otolaryngology - Head and Neck Surgery, The Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - C Kelly
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Kovarik
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - M Jackson
- Department of Clinical Oncology, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - C Paterson
- Department of Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK; University of Glasgow, Glasgow, UK
| | - S P Munro
- Newcastle University Medical School, Newcastle upon Tyne, UK
| | - A Wilson
- Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Sunderland, UK
| | - M S Iqbal
- Newcastle University, Newcastle upon Tyne, UK.
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Khan J, Ullah A, Goodbee M, Lee KT, Yasinzai AQK, Lewis JS, Mesa H. Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances. Cancers (Basel) 2023; 15:3373. [PMID: 37444484 DOI: 10.3390/cancers15133373] [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: 03/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Acinic cell carcinoma (AciCC) comprises 6-7% of all salivary gland neoplasms and is the second most common salivary gland malignancy in children. Like many salivary gland carcinomas, it is considered low grade but occasionally it behaves aggressively. Understanding the risk factors associated with recurrence, metastasis, and death is important to determine the counseling and management of individual patients. Older population-based studies are presumed to have been confounded by the misclassification of other neoplasms as AciCC, in particular secretory carcinoma and cystadenocarcinoma. Since diagnostic tools to reliably separate these entities have been available for over a decade, reevaluation of epidemiologic data limited to the 21st century should allow a better characterization of the clinicopathological characteristics of AciCC. METHODS Our study extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2018. Cox regression model analysis was performed to identify risk factors independently affecting survival. RESULTS Data for 2226 patients with AciCC were extracted from the database. Most patients were females: 59%, and white: 80.5%, with a mean age at diagnosis of 51.2 (SD ± 18.7) years. Most cases (81%) were localized at presentation. Tumor size was less than 2 cm in 42%, 2-4 cm in 47%, and >4 cm in 11%. Low-grade tumors had 5-year survival > 90%, whereas high-grade tumors had survival < 50%. Of the patients with known lymph node status only 7.3% had nodal metastases. Distant metastases were documented in 1.1%, involving lungs 44%, bone 40%, liver 12%, and brain 4%. The most common treatment modality was surgery alone: 63.6% followed by surgery and adjuvant radiation: 33%. A few received chemotherapy (1.8%) or multimodality therapy (1.2%). The 5-year overall survival rate was 90.6% (95%CI 89.1-91.9), and disease-specific survival was 94.6% (95%CI 93.3-95.6). Multivariable cox regression analysis showed that undifferentiated (HR = 8.3) and poorly differentiated tumor grade (HR = 6.4), and metastasis (HR = 5.3) were the worst independent prognostic factors. Other poor risk factors included age > 50 (HR = 3.5) and tumor size > 4 cm (HR = 2.5). CONCLUSIONS In the US, AciCC is more common in middle age white females, and most tumors are less than 4 cm and localized at diagnosis. The most relevant negative prognostic factor was high tumor grade which was associated with higher hazard ratios for death than all other variables, including regional or distant metastases at presentation.
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Affiliation(s)
- Jaffar Khan
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Asad Ullah
- Department of Pathology, Microbiology, Immunology Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mya Goodbee
- Medical College of Georgia, Augusta, GA 30912, USA
| | | | | | - James S Lewis
- Department of Pathology, Microbiology, Immunology Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hector Mesa
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Mantsopoulos K, Thimsen V, Sievert M, Balk M, Grundtner P, Gostian AO, Koch M, Iro H. Limited parotid surgery as sole form of treatment for carefully selected malignant tumours of the parotid gland: Still sufficient on the long-term? Am J Otolaryngol 2023; 44:103735. [PMID: 36535225 DOI: 10.1016/j.amjoto.2022.103735] [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: 10/27/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of the study was to investigate the oncological and functional outcome following extracapsular dissection as the sole form of treatment in locally limited low-grade malignant parotid tumours in the long term. METHODS The records of all patients treated for T1-T2 low-grade malignant tumours of the parotid gland solely by means of extracapsular dissection between 2005 and 2017 were studied retrospectively. RESULTS A total of 16 cases formed our study sample (7 men, 9 women). Their mean age was 50.2 years (21-84 years). Mean follow-up was 107 months (60-201 months). In 6 cases the tumour was an acinic cell carcinoma, in 9 cases a mucoepidermoid carcinoma and in one case a basal cell adenocarcinoma. Regarding the T category, the tumour was Tis in one case, T1 in 12 cases and T2 in three cases. The five-year disease-specific survival rate was 100 %, as was local disease control. Facial nerve function was House-Brackmann grade I without exception. CONCLUSIONS Our study showed very encouraging long-term 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. LAY SUMMARY The "one-size-fits-all" strategy of complete parotidectomy with neck dissection might be tantamount to overtreatment by less aggressive cases of parotid cancer. Extracapsular dissection seems to be oncologically sufficient for carefully selected T1-T2 low-grade cases in the long-term in patients with ensured follow-up.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Vivian Thimsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias Balk
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Philipp Grundtner
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Antoniu-Oreste Gostian
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Venkatasami M, Harrison K. Primary acinic cell carcinoma in an adolescent female. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
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Zhang D, Wei Y, Chai Y, Qi F, Dong M. Prognostic Assessment and Risk Stratification in Patients With Postoperative Major Salivary Acinar Cell Carcinoma. Otolaryngol Head Neck Surg 2023; 168:1119-1129. [PMID: 36939406 DOI: 10.1002/ohn.195] [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: 08/10/2022] [Revised: 10/05/2022] [Accepted: 10/18/2022] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate the clinicopathological features and prognosis of postoperative major salivary acinar cell carcinoma (MSACC) and develop a prognostic model. STUDY DESIGN Retrospective cohort analysis of a public database. SETTING Patients with MSACC were identified from the Surveillance, Epidemiology, and End Results database (1975-2019). METHODS Overall survival (OS) was evaluated using Kaplan-Meier curves and a log-rank test. Univariate and multivariate Cox analyses were performed to explore independent prognostic factors. The prognostic model was constructed using screened variables and further visualized with a nomogram and web calculator, and assessed by concordance index, the area under the curve, calibration curve, and decision-making curve analysis. RESULTS An upward trend in the incidence of MSACC was observed throughout the study period. A total of 1398 patients were enrolled (training cohort: 978; validation cohort: 420), and the 5- and 10-year OS rates were 97.7% and 81.6%, respectively. Age, marital status, sex, histological grade, T stage, and lymph node status were identified as prognostic factors for OS. A novel nomogram was developed and showed excellent discrimination and clinical applicability. Additionally, a web calculator was designed to dynamically predict patient survival. Based on the nomogram-based score, a risk stratification system was constructed to distinguish patients with different risks. The OS of high-risk patients was significantly lower than that of the low-risk subgroup. CONCLUSION Long-term survival in postoperative MSACC was influenced by 6 prognostic factors. The proposed model enables individualized survival prediction and risk stratification, prompting us to be vigilant in high-risk subgroups and consider timely adjustment of subsequent treatment.
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Affiliation(s)
- Di Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuce Wei
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Chai
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Qi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Mei Dong
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Krishnan V, Nguyen L, Shen R, Lieu D, De Peralta-Venturina M, Fan X. NOR-1 (NR4A3) immunostaining on cytologic preparations for the preoperative diagnosis of acinic cell carcinoma of the salivary gland. J Am Soc Cytopathol 2022; 11:352-358. [PMID: 36058827 DOI: 10.1016/j.jasc.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Acinic cell carcinoma of the salivary gland (ACC-SG) is characterized by recurrent rearrangements in the nuclear receptor subfamily 4 group A member 3 (NR4A3). Immunostaining using an antibody targeting this rearrangement, neuron-derived orphan receptor 1 (NOR-1), has been recently studied on surgical specimens and cell block material of fine-needle aspirates for the diagnosis of ACC-SG. Our goal was to evaluate whether NOR-1 immunostaining could reliably be performed on destained cytologic preparations. MATERIALS AND METHODS This was a retrospective multi-institutional study. Immunostaining with the NOR-1 antibody (sc-393902 [H-7], Santa Cruz Biotechnology Inc.) was performed at a titer of 1:30 on destained cytologic preparations. ACC-SG cases (n = 17) were represented by twelve cases with alcohol-fixed preparations (n = 12), including direct smears and SurePath preparations, as well as 5 cases with air-dried preparations (n = 5). These were compared to 27 mimicker lesions (n = 27): normal acini (4), chronic sialadenitis (3), oncocytoma (2), pleomorphic adenoma (6), Warthin tumor (8), mucoepidermoid carcinoma (1), secretory carcinoma (2), and salivary duct carcinoma (1). RESULTS The positivity of NOR-1 in ACC-SG cases was 100% on destained alcohol-fixed preparations (12/12) and 60% on air-dried preparations (3/5). All 27 mimicker lesions were negative for NOR-1 (0/27). Evaluation of 2 ACC-SG cases with both types of cytologic preparations showed that NOR-1 was positive on the alcohol-fixed slides but negative on the air-dried slides. CONCLUSIONS NOR-1 immunostaining can reliably be performed on alcohol-fixed direct smears and liquid-based preparations for the diagnosis of ACC-SG. Air-dried preparations show a lower positivity rate and may be less suitable for diagnostic immunostaining.
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Affiliation(s)
- Vimal Krishnan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Luan Nguyen
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Rulong Shen
- Department of Pathology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | | | - Xuemo Fan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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Hong WJ, Chang SL, Tsai CJ, Wu HC, Chen YC, Yang CC, Ho CH. The effect of adjuvant radiotherapy on clinical outcomes in early major salivary gland cancer. Head Neck 2022; 44:2865-2874. [PMID: 36165049 DOI: 10.1002/hed.27203] [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: 06/08/2022] [Revised: 08/19/2022] [Accepted: 09/09/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND This study investigated the effects of adjuvant radiotherapy on outcomes in early-stage major salivary gland cancers. METHODS A total of 655 patients were identified, including 355 (54.2%) received adjuvant radiotherapy and 300 (45.8%) had surgery alone. The effect of adjuvant radiotherapy on 5-year locoregional recurrence and disease-specific survival (DSS) was calculated using the Kaplan-Meier method, Wilcoxon rank sum test, and Cox proportional hazards model. RESULTS There were no significant differences in locoregional recurrence and DSS between patients receiving adjuvant radiotherapy and those not in both univariate and multivariable analysis. Although patients with positive margin status had a higher locoregional recurrence and those with moderate/poor differentiation had a worse DSS, stratified analysis still indicated there were no protective effects from the use of adjuvant radiotherapy. CONCLUSIONS The use of adjuvant radiation therapy was not associated with improved locoregional recurrence and DSS, even for those with high-risk histopathological factors.
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Affiliation(s)
- Wei-Ju Hong
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan
| | - Shih-Lun Chang
- Department of Otolaryngology - Head and Neck Surgery, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Chia-Jen Tsai
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan
| | - Hung-Chang Wu
- Division of Hematology and Oncology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Yi-Chen Chen
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Ching-Chieh Yang
- Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.,Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
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Rodrigues de Sousa M, Martins S, Soares N, Coelho L, Neto T, Balhau R. Acinic cell carcinoma emerging as a paraneoplastic Cushing's syndrome: A systematic review. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Pang Y, Sun L, Liu H, Ma J. Differential diagnosis and treatment of salivary secretory carcinoma and acinic cell carcinoma. Oral Oncol 2021; 119:105370. [PMID: 34157553 DOI: 10.1016/j.oraloncology.2021.105370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 02/08/2023]
Abstract
Secretory carcinoma (SC) and acinic cell carcinoma (AciCC) are two rare tumors originating in the salivary gland of the head and neck. Before the World Health Organization (WHO) classified SC as a new entity in 2017, the majority of SC cases were incorrectly diagnosed as AciCC. Indeed, they are similar in biological behaviors, clinical manifestations and histomorphological features. Especially, SC and zymogen granule-poor AciCC are difficult to differentiate, which brings a tough challenge in clinical diagnosis. This article provides an updated understanding of the differential diagnosis in SC and AciCC from two main perspectives: histopathology and molecular genetics. The targeted therapies for both tumors are also mentioned. It aims to give some hints in clinical diagnosis and treatment, in hopes that patients with adequate diagnosis could obtain the opportunityformore effective treatment.
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Affiliation(s)
- Yu Pang
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province 610041, PR China.
| | - Lingqi Sun
- Department of Neurology, Air Force Hospital of Western Theater Command, Chengdu, Sichuan Province 610041, PR China
| | - Huijia Liu
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China
| | - Ji Ma
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China.
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Dos Santos ES, Rodrigues-Fernandes CI, Speight PM, Khurram SA, Alsanie I, Costa Normando AG, Prado-Ribeiro AC, Brandão TB, Kowalski LP, Silva Guerra EN, Lopes MA, Vargas PA, Santos-Silva AR, Leme AFP. Impact of tumor site on the prognosis of salivary gland neoplasms: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 162:103352. [PMID: 33991662 DOI: 10.1016/j.critrevonc.2021.103352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/28/2021] [Accepted: 05/08/2021] [Indexed: 01/05/2023] Open
Abstract
In numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a meta-analysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrence-free survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
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Affiliation(s)
| | | | - Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Ibrahim Alsanie
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom; Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Ana Carolina Prado-Ribeiro
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology A C Camargo Cancer Center, São Paulo, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Adriana Franco Paes Leme
- Brazilian Bioscience National Laboratory, Brazil Center of Research in Energy and Materials, Campinas, Brazil
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Intensity Modulated Radiotherapy with Carbon Ion Radiotherapy Boost for Acinic Cell Carcinoma of the Salivary Glands. Cancers (Basel) 2021; 13:cancers13010124. [PMID: 33401730 PMCID: PMC7795372 DOI: 10.3390/cancers13010124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Acinic cell carcinoma is a rare disease treated usually by surgery. The role of radiotherapy is controversially discussed. In this retrospective analysis based on 15 patients undergoing postoperative or definitive radiotherapy (intensity-modulated radiotherapy, IMRT) with carbon ion radiotherapy boost leads to excellent results after R1-resection, and is a promising treatment modality in inoperable patients. G1-2 xerostomia, dysgeusia, and trismus were the main reported morbidity symptoms after radiotherapy. Confirmation of the results with larger patient cohorts is needed. Abstract Aim: to report clinical outcome in patients with acinic cell carcinoma of the salivary glands treated with intensity-modulated radiotherapy (IMRT) and carbon ion radiotherapy (CIRT) boost. Materials and Methods: all patients with acinic cell carcinoma of the salivary glands treated at the Heidelberg Ion-Beam Therapy Center were considered for this retrospective analysis. All patients received a CIRT boost with 18–24 Gy radiobiologic effectiveness (RBE)-weighted dose in 3 Gy RBE-weighted dose per fraction followed by IMRT, with 50–54 Gy in 2 Gy per fraction. Disease outcome was evaluated for local (LR), nodal (NR), distant recurrence (DR), and disease-free (DFS) and overall survival (OS). Morbidity was scored based on Common Terminology Criteria for Adverse Events (CTCAE) version 5. Descriptive statistics and the Kaplan-Meier method were used for analysis. Results: fifteen patients were available for analysis. Median follow-up after radiotherapy was 43 months. Six patients were treated for primary disease and nine for recurrent disease. Eight patients were treated with radiotherapy for macroscopic disease. Disease recurrence was observed in four patients: 1 LR, 2 NR, and 2 DR; 5-year local control, DFS, and OS were 80%, 52%, and 80%, respectively. No radiotherapy-related G3-5 morbidity was observed. Conclusion: In acinic cell carcinoma, IMRT with carbon ion radiotherapy boost leads to excellent results after R1-resection and is a promising treatment modality for definitive treatment in inoperable patients.
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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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13
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Starek I, Salzman R, Skalova A. Heterotopic acinic cell carcinoma and its clinical implications. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:13-18. [PMID: 33177745 DOI: 10.5507/bp.2020.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 10/05/2020] [Indexed: 11/23/2022] Open
Abstract
This is a review of the clinical and histopathological published data on very rare heterotopic acinic cell carcinomas (AcCCs) with suggested optimal management. Extrasalivary AcCCs originate primarily in parotid lymph nodes. They present at low clinical stage, show mostly low-grade histopathology and are circumscribed with a complete nodal capsule. Extracapsular dissection was advocated as adequate therapy. In rare cases with positive surgical margins, a completion parotidectomy or adjuvant radiotherapy should follow. Heterotopic high-grade AcCCs are rare, necessitating radical surgery including neck dissection and adjuvant radiotherapy. The short term prognosis is excellent, long term outcomes are not known. Longer term follow-up is essential.
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Affiliation(s)
- Ivo Starek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Richard Salzman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Alena Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University Prague, Czech Republic
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14
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Kaya EA, Taylor ZC, Mitchell BJ, Guss ZD, Bunn JD, Fairbanks RK, Lamoreaux WT, Wagner AE, Peressini BJ, Lee CM. Clinicopathologic Features and Survival Trends for Acinic Cell Carcinoma of the Major Salivary Glands: A Surveillance, Epidemiology, and End Results Population Analysis. World J Oncol 2020; 11:188-196. [PMID: 33117462 PMCID: PMC7575277 DOI: 10.14740/wjon1312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/31/2020] [Indexed: 12/18/2022] Open
Abstract
Background We analyzed a population-based national registry to identify the most influential patient pretreatment and treatment factors affecting overall survival (OS) and cause-specific survival (CSS) in patients diagnosed with acinic cell carcinoma (ACC) of the major salivary glands. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute (NCI) related to survival, a total of 1,254 patients with diagnosed ACC of the major salivary glands from 1975 to 2016 met inclusion criteria. Factors significant for OS and CSS were determined using univariate and multivariate analysis with the Cox proportional hazards model. Results Univariate OS analysis demonstrated that surgery favorably influenced longer survival compared to no surgery (hazard ratio (HR) 2.35, P < 0.05). Patient age was found to be highly predictive of superior OS (divided into 10-year age bands, P < 0.0001, younger age better). In multivariate OS analysis, there were statistically significant worse outcomes for men (HR 1.54, P < 0.05), grades III/IV (HR 2.5, P < 0.05), and distant disease (HR 3.55, P < 0.05) or regional disease (HR 1.22, P < 0.05). Patients diagnosed during years 1996 - 2016 had better OS when compared to earlier decades 1975 - 1995 (HR 1.38, P < 0.05). In univariate analysis, the mean CSS for grades I, II, and III/IV were 429 months (95% confidence interval (CI), ± 38.39), 426 months (95% CI, ± 25.73) and 198 months (95% CI, ± 66.38). Multivariate analysis of CSS further demonstrated that there were statistically significant worse outcomes for men (HR 1.68, P < 0.05), grade III/IV (HR 3.2, P < 0.05), tumor size greater than 40 mm (P < 0.001), and distant disease (HR 4.48, P < 0.05) or regional disease (HR 1.84, P < 0.05). Conclusions To our knowledge, this is the largest population-based study of OS and CSS of major salivary gland ACC. We found that the patient pretreatment and treatment factors including younger age at diagnosis, female sex, early stage, lower grade, surgical excision, and recent year of diagnosis are associated with improved survival in patients diagnosed with ACC of the major salivary glands. We hope that this information will aid in construction of further research projects that better refine optimal treatment protocol of individualized patient care.
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Affiliation(s)
- Erin A Kaya
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA.,Washington State University (WSU) Elson S. Floyd College of Medicine (ESFCOM), Spokane, WA, USA
| | - Zachary C Taylor
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA.,Washington State University (WSU) Elson S. Floyd College of Medicine (ESFCOM), Spokane, WA, USA
| | | | - Zachary D Guss
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA
| | | | - Robert K Fairbanks
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA
| | - Wayne T Lamoreaux
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA
| | - Aaron E Wagner
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA
| | | | - Christopher M Lee
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA, USA
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15
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NR4A3 Immunohistochemistry Reliably Discriminates Acinic Cell Carcinoma from Mimics. Head Neck Pathol 2020; 15:425-432. [PMID: 32910350 PMCID: PMC8134602 DOI: 10.1007/s12105-020-01213-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
Acinic cell carcinoma (AciCC) harbors a recurrent t(4;9)(q13;q31) translocation, which leads to upregulation of Nuclear Receptor Subfamily 4 Group A Member 3 (NR4A3). Previous work on tissue microarrays suggests that NR4A3 immunohistochemistry (IHC) may be useful in the diagnosis of AciCC. Thus far, only a single study has evaluated the utility of NR4A3 immunohistochemistry (IHC) in the diagnosis of AciCC, using a tissue microarray to assess most non-AciCC tumor types. Herein we evaluate the diagnostic performance of NR4A3 IHC for AciCC in a large cohort of 157 salivary gland tumors, using whole tissue sections. The cohort consisted of 37 AciCC (6 of them (16%) with high grade transformation), 30 secretory carcinomas (SC), and 90 additional salivary gland tumors, including mucoepidermoid carcinomas (MEC), polymorphous adenocarcinomas (PAC), pleomorphic adenomas (PA), salivary duct carcinomas (SDC), and adenoid cystic carcinomas (AdCC). NR4A3 nuclear staining by IHC was considered positive if present in more than 5% of tumor cells. Overall, 92% of AciCC (34/37) expressed NR4A3 by IHC, with strong (89%) or moderate (3%) nuclear staining, yielding a sensitivity of 92%. IHC detected NR4A3 expression in all cases of recurrent/metastatic AciCC and tumors with high grade transformation. Importantly, all SC were negative for NR4A3 IHC, with no staining in 28/30 cases and weak focal staining, in < 5% of cells, in 2/30 (7%). Similarly, all MEC (20/20), SDC (20/20) and AdCC (10/10) were negative for NR4A3 by IHC, as were most PA (18/20; 15%) and PAC (18/20; 5%). Two PA and two PAC showed multifocal expression of NR4A3 in more than 5% of cells, of weak intensity in 3 cases and moderate in 1 PAC, yielding an overall specificity of 97% for NR4A3 IHC for the diagnosis of AciCC. In conclusion, NR4A3 is a highly sensitive and specific immunohistochemical marker for AciCC; moderate to strong and/or diffuse NR4A3 expression is a consistent and diagnostic feature of AciCC.
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16
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Yibulayin F, Feng L, Wang M, Lu MM, Luo Y, Liu H, Yang ZC, Wushou A. Head & neck acinar cell carcinoma: a population-based study using the seer registry. BMC Cancer 2020; 20:631. [PMID: 32641007 PMCID: PMC7346396 DOI: 10.1186/s12885-020-07066-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/12/2020] [Indexed: 12/17/2022] Open
Abstract
Background To explore the clinicopathologic characteristics, treatment and prognostic factors of head and neck acinar cell carcinoma (HNACC) comprehensively. Methods A population-based study was conducted using data from the Surveillance, Epidemiology, and End Results database (1975–2016). Overall survival (OS) and HNACC-specific survival of patients with different clinicopathologic variables were compared using the Kaplan-Meier method and Cox multivariate regression. Results A total of 2624 primary HNACC cases (1052 males, 1572 females) were identified. There was a significant difference in gender distribution. Among the total cohort, 2416 cases originated from salivary glands, including 2325 parotid gland ACC cases. Regardless of confounding factors, the 10-year and 20-year disease-specific survival (DSS) was 93.6 and 90%, respectively. Surgery was favourably associated with better DSS and OS [HR = 0.13, P = 0.0092 and HR = 0.23, P = 0.0203]. Gender was the only demographic independent prognostic factor for both DSS and OS [Male vs female, HR = 3.3, P = 0.0028 for DSS; HR = 2.44, P = 0.0376 for OS]. Higher pathological grade was adversely associated with DSS and OS [Grade II, HR = 4.03, P = 0.0444; Grade III + IV, HR = 35.64, P = 0.0000 for DSS; Grade III + IV, HR = 4.49, P = 0.0000 for OS, Grade I as reference]. In addition, TNM/AJCC stage was commonly associated with prognosis. Conclusion Surgery was the only favourable prognostic indicator for both DSS and OS. Gender, age, pathological differentiation and TNM/AJCC stage were independent prognostic factors for survival.
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Affiliation(s)
- Feiluore Yibulayin
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.,Department of Preventive Medicine, School of Public Health, Shanghai Medical College, Fudan University, 138 Yi xue yuan Road, Shanghai, 200001, People's Republic of China
| | - Lei Feng
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Meng Wang
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Meng-Meng Lu
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Yuan Luo
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Hui Liu
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Zhi-Cheng Yang
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.
| | - Alimujiang Wushou
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.
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17
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Park YM, Yoon SO, Kim JH, Kang MS, Kim DH, Koh YW, Kim SH, Lim JY, Choi EC. Comprehensive Analysis of Clinicopathologic Factors Predictive of an Unfavorable Prognosis in Patients With Acinic Cell Carcinoma of the Parotid Gland. Clin Exp Otorhinolaryngol 2020; 14:108-115. [PMID: 32392906 PMCID: PMC7904441 DOI: 10.21053/ceo.2019.01550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/18/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives. In subset of patients, acinic cell carcinoma (AcCC) exhibits aggressive features such as recurrence, distant metastasis, and mortality. This study aimed to investigate clinicopathologic factors influencing patients’ prognosis and to identify adverse features predictive of an unfavorable prognosis. Methods. Between January 2000 and December 2016, 59 patients with AcCC were enrolled in this study. Results. The patients’ 5-year overall survival rate was 93.3%, and their 5-year recurrence-free survival rate was 80.5%. During the study period, recurrence occurred in 10 patients. The mean time to recurrence after surgery was 26 months (range, 5–60 months). During the study period, three patients died from the disease. Univariate analysis showed that sex, surgical extent, extranodal extension, T classification, and TNM stage were significantly associated with disease recurrence. Multivariate analysis showed that, among the clinicopathologic factors included in the analysis, only TNM stage displayed a statistically significant correlation with disease recurrence. Conclusion. Surgical treatment alone yielded good results for AcCC, and additional treatment did not affect the recurrence-free survival rate or the overall survival rate, even when the resection margin was less than 1 mm. Other pathologic factors did not show prognostic significance for disease recurrence or death.
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Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Och Yoon
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Hyun Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Da Hee Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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18
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Yue LE, Samankan S, Liu X, Sharif KF, Everest S, Singh T, Dhorajiya P, Baik FM, Khorsandi A, Stevens TM, Brandwein-Weber M, Urken ML. Ten patients with high-grade transformation of acinic cell carcinomas. Pathol Res Pract 2020; 216:152767. [DOI: 10.1016/j.prp.2019.152767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/15/2019] [Accepted: 11/27/2019] [Indexed: 01/18/2023]
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19
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Advances and challenges in precision medicine in salivary gland cancer. Cancer Treat Rev 2019; 80:101906. [PMID: 31644971 DOI: 10.1016/j.ctrv.2019.101906] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/11/2019] [Accepted: 10/07/2019] [Indexed: 12/13/2022]
Abstract
Salivary gland cancer (SGC) is a rare malignancy consisting of 22 subtypes with different genetic, histological and clinical characteristics. This rarity and heterogeneity makes systemic treatment of recurrent or metastatic (R/M) disease challenging. Use of chemotherapy is scarcely studied and chemotherapy at best has moderate effects. New therapeutic strategies are therefore warranted, but advances made in SGC are lagging behind on advances made in more common cancers. By unraveling tumor characteristics of SGC, such as genetic alterations and protein expression profiles, therapeutic strategies tailored to the patient's tumor can be rationalized. This genomic profiling and mapping of immunohistochemical expression profiles is essential in the search for a suitable treatment approach. Thereby, it alleviates the paucity in systemic treatment options and can significantly alter the prognosis of patients with R/M SGC. This review aims to give a comprehensive overview of known genetic alterations and expression profiles amenable for targeted therapy in every histological subtype of SGC. We discuss the remaining knowledge gaps and the implications of these targets for future studies and personalized treatments, thereby aiding clinicians faced with this rare and heterogeneous type of cancer.
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20
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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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21
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Elhusseiny KM, Abd-Elhay FAE, Kamel MG, Abd El Hamid Hassan HH, El Tanany HHM, Hieu TH, Tieu TM, Low SK, Hou V, Dibas M, Huy NT. Examined and positive lymph nodes counts and lymph nodes ratio are associated with survival in major salivary gland cancer. Head Neck 2019; 41:2625-2635. [PMID: 30905082 DOI: 10.1002/hed.25742] [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] [Received: 04/24/2018] [Revised: 10/22/2018] [Accepted: 03/05/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We aimed to investigate the prognostic role of examined (dissected) lymph nodes (ELNs), negative LNs (NLNs), and positive (metastatic) LNs (PLNs) counts and LN ratio (LNR = PLNs/ELNs×100) in patients with major salivary gland cancer (SGC). METHODS Data were retrieved for major SGC patients diagnosed between 1988 and 2011 from Surveillance, Epidemiology, and End Results program. RESULTS We have included 5446 patients with major SGC. Most patients had parotid gland cancer (84.61%). Patients having >18 ELNs, >4 PLNs, and >33.33% LNR were associated with a worse survival. Moreover, older age, male patients, grade IV, distant stage, unmarried patients, submandibular gland cancer, and received chemotherapy but not received surgery were significantly associated with a worse survival. CONCLUSIONS We demonstrated that patients with >18 ELNs and >4 PLNs counts, and >33.33% LNR were high-risk group patients. We strongly suggest adding the ELNs and PLNs counts and/or LNR into the current staging system.
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Affiliation(s)
- Khaled Mosaad Elhusseiny
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt.,Online Research Club (http://www.onlineresearchclub.org/
| | | | - Mohamed Gomaa Kamel
- Online Research Club (http://www.onlineresearchclub.org/.,Faculty of Medicine, Minia University, Minia, Egypt
| | - Heba Hassan Abd El Hamid Hassan
- Online Research Club (http://www.onlineresearchclub.org/.,Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | | | - Truong Hong Hieu
- Online Research Club (http://www.onlineresearchclub.org/.,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thuan Minh Tieu
- Online Research Club (http://www.onlineresearchclub.org/.,McMaster University, Hamilton, Ontario, Canada
| | - Soon Khai Low
- Online Research Club (http://www.onlineresearchclub.org/.,School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | - Vincent Hou
- Online Research Club (http://www.onlineresearchclub.org/.,McMaster University, Hamilton, Ontario, Canada
| | - Mahmoud Dibas
- Online Research Club (http://www.onlineresearchclub.org/.,Sulaiman Al Rajhi Colleges, Al Bukayriya, Saudi Arabia
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam.,Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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22
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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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23
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Said-Al-Naief N, Carlos R, Vance GH, Miller C, Edwards PC. Combined DOG1 and Mammaglobin Immunohistochemistry Is Comparable to ETV6-breakapart Analysis for Differentiating Between Papillary Cystic Variants of Acinic Cell Carcinoma and Mammary Analogue Secretory Carcinoma. Int J Surg Pathol 2017; 25:127-140. [PMID: 27670353 DOI: 10.1177/1066896916670005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
BACKGROUND We investigated the reliability of combined DOG1 and mammaglobin immunohistochemistry compared with ETV6 fluorescence in situ hybridization (FISH) in the assessment of salivary tumors previously diagnosed as acinic cell carcinoma (ACC). Ultrastructural features of cases reclassified as mammary analogue secretory carcinoma (MASC) were assessed by transmission electron microscopy (TEM). METHODS Immunohistochemical (IHC) reactivity to DOG1 and mammaglobin was validated against FISH targeting the ETV6 gene in all 14 cases. RESULTS Three cases with papillary cystic histomorphology previously diagnosed as ACC were revised to MASC. TEM features of the ETV6 rearrangement-positive MASC cases showed large numbers of secretory granules with extrusion into the intercellular spaces, well-developed endoplasmic reticulum, lipid-laden vacuoles, well-formed microvilli, and large lining cystic spaces. CONCLUSIONS Combined DOG1 and mammaglobin immunohistochemistry is comparable to ETV6 -breakapart analysis for differentiating between papillary cystic variants of ACC and MASC.
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Affiliation(s)
| | - Roman Carlos
- 2 Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Gail H Vance
- 3 Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis, IN, USA
| | - Caroline Miller
- 4 Department of Anatomy and Cell Biology Indiana University School of Medicine Indianapolis, IN, USA
| | - Paul C Edwards
- 5 Department of Oral Pathology, Medicine and Radiology Indiana University School of DentistryIndianapolis, IN, USA
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24
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Liu Y, Su M, Yang Y, Zhao B, Qin L, Han Z. Prognostic Factors Associated With Decreased Survival in Patients With Acinic Cell Carcinoma of the Parotid Gland. J Oral Maxillofac Surg 2016; 75:416-422. [PMID: 27474461 DOI: 10.1016/j.joms.2016.06.185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/14/2016] [Accepted: 06/19/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Acinic cell carcinoma (ACC) of the parotid gland is relatively rare. This study aimed to estimate 5-year survival and to identify prognostic factors associated with survival of ACC of the parotid gland. MATERIALS AND METHODS Thirty-seven patients with ACC of the parotid gland were included in this retrospective cohort study. They were treated in Beijing Stomatological Hospital from January 2000 to December 2011. Predictor variables, including age, gender, tumor stage, nodal stage, perineural invasion, and margin status, were analyzed. The Cox regression model was used to determine prognostic factors for overall survival (OS) and disease-free survival (DFS). RESULTS Of the 37 patients, 20 were men (54.1%). Mean age was 42 years (range, 13 to 73 yr). Six patients (16.2%) had T3 or T4 tumors and 5 (13.5%) had positive neck nodes. The 5-year OS and DFS were 86.5 and 78.3%, respectively. Positive margin status was associated with worse OS. Patients older than 60 years with a fixed mass, high-grade tumor and nodal stage, perineural invasion, and angiolymphatic invasion had adverse OS and DFS (P < .05). CONCLUSIONS The present study identified several important prognostic factors associated with OS and DFS in patients with ACC. These prognostic variables include symptoms at presentation, clinical tumor stage and pathologic nodal status, and histopathology-related factors. All these factors were important in patient therapy and could prolong survival rate.
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Affiliation(s)
- Yanbin Liu
- Attending Physician, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Ming Su
- Attending Physician, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Yucheng Yang
- Resident Physician, Department of Stomatology, Weifang Yidu Central Hospital, Weifang, China
| | - Bin Zhao
- Resident Physician, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Lizheng Qin
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Zhengxue Han
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China.
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25
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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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