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Nachtsheim L, Jansen L, Shabli S, Arolt C, Quaas A, Klussmann JP, Mayer M, Wolber P. Recurrence after primary salivary gland carcinoma: Frequency, survival, and risk factors. Head Neck 2024. [PMID: 39073241 DOI: 10.1002/hed.27880] [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: 03/22/2024] [Revised: 06/18/2024] [Accepted: 07/07/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Primary salivary gland carcinomas (SGC) are rare neoplasms that present therapeutic challenges especially in recurrent tumors. The aim of this study was to investigate the incidence and distribution of tumor recurrence, associated risk factors, and survival. METHODS This analysis includes data from 318 patients treated for SGC between 1992 and 2020. Survival analysis was performed using the Kaplan-Meier method. Univariate and multivariate analyses were used to identify risk factors associated with recurrence. RESULTS 21.7% of the patients developed recurrent disease after a mean of 38.2 months. In multivariate analysis, positive-resection margins, vascular invasion, and tumor localization in the submandibular gland and small salivary glands were independent factors for recurrence. The 5-year overall survival was 67%, the 5-year disease-free survival was 54%. CONCLUSION Tumor recurrence in SGC occurred in one out of five patients. In highly aggressive entities and patients with risk factors, treatment intensification should be considered.
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Affiliation(s)
- Lisa Nachtsheim
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - L Jansen
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - S Shabli
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - C Arolt
- Institute of Pathology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Quaas
- Institute of Pathology, Medical Faculty, University of Cologne, Cologne, Germany
| | - J P Klussmann
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Mayer
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - P Wolber
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
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2
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Song Y, He Y, Li H, Zhao L, Liu Y, Liu S. Intraparotid node metastasis affects the long-term survival of patients with resectable recurrent parotid gland carcinoma. Eur Arch Otorhinolaryngol 2023; 280:5547-5555. [PMID: 37493846 DOI: 10.1007/s00405-023-08142-2] [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: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE The recurrence rate of parotid gland cancer is high, but research on the prognosis of recurrent parotid gland cancer (RPC) is relatively limited. We aim to determine the potential prognosis factors of RPC. STUDY DESIGN Retrospective cohort analysis. SETTING Tertiary cancer center. METHODS We conducted a retrospective review from 2012 to 2021 on RPC patients treated at the China National Cancer Center (CNCC). To analyze the impact of various variables on overall survival (OS) after recurrence, a univariate and multivariate Cox proportional hazard model was employed. RESULTS A total of 50/218 (23.0%) patients diagnosed with RPC and underwent surgery. The 5-year OS of all RPC patients in this cohort was 61.9%. 5 of 50 patients (10%) exhibited intraparotid node (IPN) metastasis. By univariate and multivariate analyses, we found that IPN metastasis was one of the prognostic factors of OS (p = 0.039) in RPC patients. The presence of IPN metastasis was also related to poor survival in individuals with negative cervical lymph nodes (CN0) (p = 0.011). In terms of the influence of surgical margins on prognosis, our findings revealed that RPC patients with negative margins exhibited a higher survival result than those with positive margins (p = 0.002). CONCLUSION According to this study, IPN metastasis indicate a high incidence of mortality in recurrent parotid cancer patients. Particularly, in CN0 patients, the presence of IPN metastasis was associated with poor survival in CN0 patients.
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Affiliation(s)
- Yixuan Song
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yuqin He
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Han Li
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Li Zhao
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yang Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shaoyan Liu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
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3
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Ameri A, Sourati A, Behzadi B, Lesan M, Taghizadeh-Hesary F. A comparison of two chemotherapy regimens in advanced, recurrent, or metastatic salivary gland carcinoma. Indian J Cancer 2023; 60:418-426. [PMID: 36861690 DOI: 10.4103/ijc.ijc_1226_20] [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: 03/03/2023]
Abstract
Background The efficacy of chemotherapy in locally advanced, recurrent, and metastatic salivary gland carcinomas (LA-R/M SGCs) is still undefined. We aimed to compare the efficacy of two chemotherapy regimens in LA-R/M SGC. Materials and Methods This prospective study compared paclitaxel (Taxol) plus carboplatin (TC) versus cyclophosphamide, doxorubicin, plus cisplatin (CAP) regimen in terms of overall response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), and overall survival (OS). Results Between October 2011 and April 2019, 48 patients with LA-R/M SGCs were recruited. The ORRs of first-line TC and CAP regimens were 54.2% and 36.3%, respectively (P = 0.57). The ORRs in recurrent and de novo metastatic patients were 50.0% and 37.5% for TC and CAP, respectively (P = 0.26). The median PFS of TC and CAP arms were 10.2 and 11.9 months, respectively (P = 0.91). In the subanalysis, patients with adenoid cystic carcinoma (ACC) had longer PFS in the TC arm (14.5 vs. 8.2 months, P = 0.03), irrespective of the tumor grade (low grade: 16.3 vs. 8.9 months, high grade: 11.7 vs. 4.5 months; P = 0.03). The median OS rates were 45.5 and 19.5 months for TC and CAP groups, respectively (P = 0.71). Conclusion For patients with LA-R/M SGC, there was no significant difference between first-line TC and CAP in terms of ORR, PFS, and OS.
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Affiliation(s)
- Ahmad Ameri
- Department of Clinical Oncology, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ainaz Sourati
- Department of Clinical Oncology, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnaz Behzadi
- Department of Clinical Oncology, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Lesan
- Department of Clinical Oncology, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine; Radiation Oncology Department, Iran University of Medical Sciences, Tehran, Iran
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Geiger JL, Ismaila N, Beadle B, Caudell JJ, Chau N, Deschler D, Glastonbury C, Kaufman M, Lamarre E, Lau HY, Licitra L, Moore MG, Rodriguez C, Roshal A, Seethala R, Swiecicki P, Ha P. Management of Salivary Gland Malignancy: ASCO Guideline. J Clin Oncol 2021; 39:1909-1941. [PMID: 33900808 DOI: 10.1200/jco.21.00449] [Citation(s) in RCA: 164] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations for practicing physicians and other healthcare providers on the management of salivary gland malignancy. METHODS ASCO convened an Expert Panel of medical oncology, surgical oncology, radiation oncology, neuroradiology, pathology, and patient advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2020. Outcomes of interest included survival, diagnostic accuracy, disease recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 293 relevant studies to inform the evidence base for this guideline. Six main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, and follow-up evaluations. RECOMMENDATIONS When possible, evidence-based recommendations were developed to address the diagnosis and appropriate preoperative evaluations for patients with a salivary gland malignancy, therapeutic procedures, and appropriate treatment options in various salivary gland histologies.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Marnie Kaufman
- Adenoid Cystic Carcinoma Research Foundation, Needham, MA
| | | | | | - Lisa Licitra
- Istituto Nazionale Tumori, Milan, Italy.,University of Milan, Milan, Italy
| | | | | | | | | | | | - Patrick Ha
- University of California San Francisco, San Francisco, CA
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5
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Strizova Z, Kuchar M, Capkova L, Komarc M, Skrivan J, Bartunkova J, Plzak J, Smrz D. Fas-Fas Ligand Interplay in the Periphery of Salivary Gland Carcinomas as a New Checkpoint Predictor for Disease Severity and Immunotherapy Response. Biomedicines 2021; 9:biomedicines9040402. [PMID: 33917866 PMCID: PMC8068215 DOI: 10.3390/biomedicines9040402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 02/05/2023] Open
Abstract
Salivary gland carcinomas (SGCs) are extremely morphologically heterogeneous, and treatment options for this disease are limited. Immunotherapy with immune checkpoint inhibitors (ICIs) represents a revolutionary treatment approach. However, SGCs remain largely resistant to this therapy. An increasing body of evidence suggests that resistance to ICI therapy is modulated by the Fas (CD95)–Fas ligand (FasL, CD178) interplay between tumor cells and immune cells. In this study, we examined the Fas–FasL interplay between tumor cells and tumor-infiltrating immune cells (TIICs) in the center and periphery of SGCs from 62 patients. We found that the Fas-expressing tumor cells accumulated in the center of SGC tumors with increasing tumor stage. Furthermore, this accumulation occurred regardless of the presence of TIICs expressing high levels of FasL. On the contrary, a loss of Fas-expressing TIICs with increasing tumor stage was found in the tumor periphery, whereas FasL expression in tumor cells in the tumor periphery correlated with tumor stage. These data suggest that SGC cells are resistant to FasL-induced apoptosis by TIICs but could utilize FasL to eliminate these cells in high-stage tumors to provide resistance to immunotherapy.
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Affiliation(s)
- Zuzana Strizova
- Department of Immunology, Second Faculty of Medicine, University Hospital Motol, Charles University, 15006 Prague, Czech Republic; (Z.S.); (J.B.)
| | - Martin Kuchar
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, 15006 Prague, Czech Republic; (M.K.); (J.P.)
| | - Linda Capkova
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University, 15006 Prague, Czech Republic;
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, 15006 Prague, Czech Republic;
| | - Jiri Skrivan
- Department of Otorhinolaryngology, Second Faculty of Medicine, University Hospital Motol, Charles University, 15006 Prague, Czech Republic;
| | - Jirina Bartunkova
- Department of Immunology, Second Faculty of Medicine, University Hospital Motol, Charles University, 15006 Prague, Czech Republic; (Z.S.); (J.B.)
| | - Jan Plzak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, University Hospital Motol, Charles University, 15006 Prague, Czech Republic; (M.K.); (J.P.)
| | - Daniel Smrz
- Department of Immunology, Second Faculty of Medicine, University Hospital Motol, Charles University, 15006 Prague, Czech Republic; (Z.S.); (J.B.)
- Correspondence:
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Joshi NP, Broughman JR. Postoperative Management of Salivary Gland Tumors. Curr Treat Options Oncol 2021; 22:23. [PMID: 33560478 DOI: 10.1007/s11864-021-00820-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/26/2022]
Abstract
OPINION STATEMENT Salivary gland tumors represent a heterogeneous group of neoplasms characterized by varied histologies and disease outcomes. Initial treatment for the primary and gross nodal disease is usually surgery. Management of the clinically node-negative neck depends upon the risk of lymph nodal involvement. This is usually determined by the AJCC "T" stage and histology. Both surgery and radiation may be utilized to address the lymph nodes at risk. This is especially important for minor salivary gland tumors. Radiation plays an important role in the adjuvant management of salivary gland tumors by reducing the risk of locoregional recurrence. Certain histologies like adenoid cystic carcinoma have a predilection for neurotropic spread to the skull base. Radiation is particularly important in controlling disease at the skull base. The role of concurrent chemotherapy in the adjuvant treatment of salivary gland tumors is not established and remains an area of active research. Certain histologies like salivary duct carcinoma exhibit readily identifiable molecular targets amenable to targeted therapy. Finally, advanced testing of these tumors using next-generation sequencing can also potentially identify molecular targets amenable to therapy. While useful in the management of metastatic disease, the role of these therapies in the adjuvant setting remains unknown.
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Affiliation(s)
- Nikhil P Joshi
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - James R Broughman
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, USA
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7
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Sharbel DD, Unsal AA, Groves MW, Albergotti WG, Byrd JK. Salivary Clear Cell Carcinoma Clinicopathologic Characteristics and Outcomes: A Population-Based Analysis. Ann Otol Rhinol Laryngol 2019; 128:989-996. [DOI: 10.1177/0003489419853597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Salivary clear cell carcinoma is an uncommon, low-grade malignancy for which limited data describing predictive clinicopathologic factors and treatment outcomes exist because of rarity. Methods: The authors queried the Surveillance, Epidemiology, and End Results database from 1982 to 2014. Multivariate Cox and Kaplan-Meier analyses were performed to determine disease-specific survival (DSS) and predictive clinicopathologic factors. Results: One hundred ninety-eight patients with salivary clear cell carcinoma were included. Overall incidence was 0.011 per 100 000 individuals, with no significant annual percentage change across years (−0.93%, P = .632). Five-, 10-, and 20-year DSS rates were 81.3% (n = 117), 69.6% (n = 94), and 55.3% (n = 68), respectively. Men (hazard ratio, 4.74; P = .0087) and patients with regional (hazard ratio, 5.59; P = .018) or distant (hazard ratio, 8.9; P = .01) metastases carried a worse prognosis. Five-year DSS was greater in patients with localized disease (96.36%, P < .0001) than those with regional or distant metastases. Treatment with surgery alone had better 10-year DSS (86.3%) compared with treatment with combination radiation and surgery (57.6%) or radiation monotherapy (18.75%, P < .0001). Conclusions: Salivary clear cell carcinoma carries an overall good prognosis. Patients with localized disease and those treated with surgery alone have more favorable prognoses. Male patients and those with regional or distant metastatic disease at time of presentation carry a worse prognosis. Level of Evidence: N/A
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Affiliation(s)
- Daniel D. Sharbel
- Department of Otolaryngology–Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Aykut A. Unsal
- Department of Otolaryngology–Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Michael W. Groves
- Department of Otolaryngology–Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - William G. Albergotti
- Department of Otolaryngology–Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - J. Kenneth Byrd
- Department of Otolaryngology–Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Porcheri C, Meisel CT, Mitsiadis T. Multifactorial Contribution of Notch Signaling in Head and Neck Squamous Cell Carcinoma. Int J Mol Sci 2019; 20:E1520. [PMID: 30917608 PMCID: PMC6471940 DOI: 10.3390/ijms20061520] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 12/20/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) defines a group of solid tumors originating from the mucosa of the upper aerodigestive tract, pharynx, larynx, mouth, and nasal cavity. It has a metastatic evolution and poor prognosis and is the sixth most common cancer in the world, with 600,000 new cases reported every year. HNSCC heterogeneity and complexity is reflected in a multistep progression, involving crosstalk between several molecular pathways. The Notch pathway is associated with major events supporting cancerogenic evolution: cell proliferation, self-renewal, angiogenesis, and preservation of a pro-oncogenic microenvironment. Additionally, Notch is pivotal in tumor development and plays a dual role acting as both oncogene and tumor suppressor. In this review, we summarize the role of the Notch pathway in HNSCC, with a special focus on its compelling role in major events of tumor initiation and growth.
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Affiliation(s)
- Cristina Porcheri
- University of Zurich, Institute of Oral Biology, Plattenstrasse 11, CH-8032 Zurich, Switzerland.
| | - Christian Thomas Meisel
- University of Zurich, Institute of Oral Biology, Plattenstrasse 11, CH-8032 Zurich, Switzerland.
| | - Thimios Mitsiadis
- University of Zurich, Institute of Oral Biology, Plattenstrasse 11, CH-8032 Zurich, Switzerland.
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Wang Y, Hu J, Wang Y, Ye W, Zhang X, Ju H, Xu D, Liu L, Ye D, Zhang L, Zhu D, Deng J, Zhang Z, Liu S. EGFR activation induced Snail-dependent EMT and myc-dependent PD-L1 in human salivary adenoid cystic carcinoma cells. Cell Cycle 2018; 17:1457-1470. [PMID: 29954240 DOI: 10.1080/15384101.2018.1489177] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Epithelial-to-mesenchymal transition (EMT) confers cancer cells the ability of invasion and metastasis. However, how does EMT contribute to evasion of immune surveillance is unclear, especially in salivary adenoid cystic carcinoma (SACC). In this study, we investigated the molecular link between EGF-induced EMT and the immune checkpoint ligand programmed death-ligand 1 (PD-L1) by immunoprecipitation (IP) and Westernblot analysis. Cell migration and invasion activity was assayed by transwell assay. Immunohistochemical (IHC) staining analysis was performed for measurement of EMT markers and PD-L1 expression levels in tumor tissues. We found that EGF-induced EGFR activation stabilized Snail expression and induced EMT in SACC. Interestingly, EGFR activation induced simultaneously both EMT and PD-L1 in SACC. Importantly, knockdown of Snail greatly suppressed EGF-induced EMT, but not EGF-induced PD-L1 expression; whereas knockdown of c-Myc strongly repressed PD-L1 expression, but not snail expression and EMT. The molecular link is strongly supported by robust correlations between the EMT markers and PD-L1 expression in human cancer samples.These results suggest that EGFR activated EMT and PD-L1 via two distinct mechanisms. EGFR activation induced EMT and PD-L1 expression in SACC. Snail is required for EGF-induced EMT, but not PD-L1 expression; whereas c-Myc is required for EGFR-mediated PD-L1 upregulation but not EMT. Thus, targeting activated EGFR may inhibit both EMT and PD-L1, which may potentiate the therapeutic effect of PD-L1-based immunotherapy, especially in the malignant subgroups of SACC patients with activated EGFR.
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Affiliation(s)
- Yang Wang
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Jingzhou Hu
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Yan'an Wang
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Weimin Ye
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Xiangkai Zhang
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Houyu Ju
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Dongliang Xu
- d Key Laboratory of Cell Differentiation and Apoptosis of Chinese Minister of Education , Shang hai Jiao Tong University School of Medicine , Shanghai , China
| | - Liu Liu
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Dongxia Ye
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Ling Zhang
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Dongwang Zhu
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Jiong Deng
- d Key Laboratory of Cell Differentiation and Apoptosis of Chinese Minister of Education , Shang hai Jiao Tong University School of Medicine , Shanghai , China
| | - Zhiyuan Zhang
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
| | - Shuli Liu
- a Department of Oral and Maxillofacial-Head and Neck Oncology , Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Shanghai Key Laboratory of Stomatology& Shanghai Research Institute of Stomatology , Shanghai , China.,c National Clinical Research Center of Stomatology , Shanghai , China
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Haeggblom L, Ursu RG, Mirzaie L, Attoff T, Gahm C, Nordenvall LH, Näsman A. No evidence for human papillomavirus having a causal role in salivary gland tumors. Diagn Pathol 2018; 13:44. [PMID: 30021645 PMCID: PMC6052678 DOI: 10.1186/s13000-018-0721-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/14/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Salivary gland malignancies are a very heterogeneous group of cancers, with histologically > 20 different subtypes, and prognosis varies greatly. Their etiology is unknown, however, a few small studies show presence of human papillomavirus (HPV) in some subtypes, although the evidence for HPV having a causal role is weak. The aim of this study was to investigate if HPV plays a causal role in the development of different parotid salivary gland tumor subtypes. METHODS DNA was extracted from 107 parotid salivary gland formalin fixed paraffin embedded tumors and 10 corresponding metastases, and tested for 27 different HPV types using a multiplex bead based assay. HPV DNA positive tumors were stained for p16INK4a overexpression by immunohistochemistry. RESULTS One of the 107 malignant parotid salivary gland tumors (0.93%) and its corresponding metastasis on the neck were positive for HPV16 DNA, and both also overexpressed p16INK4a. The HPV positive primary tumor was a squamous cell carcinoma; neither mucoepidermoid nor adenoid cystic tumors were found HPV positive. CONCLUSIONS In conclusion, HPV DNA analysis in a large number of malignant parotid salivary gland tumors, including 12 different subtypes, did not show any strong indications that tested HPV types have a causal role in the studied salivary gland tumor types.
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Affiliation(s)
- Linnea Haeggblom
- Department of Oncology-Pathology, Karolinska Institute, Cancer Center Karolinska, R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Ramona Gabriela Ursu
- Department of Microbiology, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania
| | - Leila Mirzaie
- Department of Oncology-Pathology, Karolinska Institute, Cancer Center Karolinska, R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Tove Attoff
- Department of Oncology-Pathology, Karolinska Institute, Cancer Center Karolinska, R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Caroline Gahm
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, 171 76 Stockholm, Sweden
| | - Lalle Hammarstedt Nordenvall
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, 171 76 Stockholm, Sweden
| | - Anders Näsman
- Department of Oncology-Pathology, Karolinska Institute, Cancer Center Karolinska, R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Clinical Pathology, Karolinska University Hospital, 171 76 Stockholm, Sweden
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11
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Emmerson E, Knox SM. Salivary gland stem cells: A review of development, regeneration and cancer. Genesis 2018; 56:e23211. [PMID: 29663717 PMCID: PMC5980780 DOI: 10.1002/dvg.23211] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 12/13/2022]
Abstract
Salivary glands are responsible for maintaining the health of the oral cavity and are routinely damaged by therapeutic radiation for head and neck cancer as well as by autoimmune diseases such as Sjögren's syndrome. Regenerative approaches based on the reactivation of endogenous stem cells or the transplant of exogenous stem cells hold substantial promise in restoring the structure and function of these organs to improve patient quality of life. However, these approaches have been hampered by a lack of knowledge on the identity of salivary stem cell populations and their regulators. In this review we discuss our current knowledge on salivary stem cells and their regulators during organ development, homeostasis and regeneration. As increasing evidence in other systems suggests that progenitor cells may be a source of cancer, we also review whether these same salivary stem cells may also be cancer initiating cells.
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Affiliation(s)
- Elaine Emmerson
- The MRC Centre for Regenerative Medicine, The University of Edinburgh, 5 Little France Drive, Edinburgh, EH16 4UU, UK
| | - Sarah M. Knox
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, University of California, 513 Parnassus Avenue, San Francisco, CA, 94143, USA
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12
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Shkedy Y, Alkan U, Mizrachi A, Shochat T, Dimitstein O, Morgenstern S, Shpitzer T, Bachar G. Fine-needle aspiration cytology for parotid lesions, can we avoid surgery? Clin Otolaryngol 2017; 43:632-637. [DOI: 10.1111/coa.13038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Shkedy
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - U. Alkan
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - A. Mizrachi
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - T. Shochat
- Departments of Medical Statistics; Rabin Medical Center; Petach Tikva Israel
| | - O. Dimitstein
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - S. Morgenstern
- Departments of Pathology & Cytology; Rabin Medical Center; Petach Tikva Israel
| | - T. Shpitzer
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
| | - G. Bachar
- Departments of Otorhinolaryngology-Head and Neck Surgery; Rabin Medical Center; Petach Tikva Israel
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13
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Recurrent parotid gland carcinoma: how effective is salvage surgery? Eur Arch Otorhinolaryngol 2017; 275:507-513. [PMID: 29196807 DOI: 10.1007/s00405-017-4829-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Recurrent parotid gland carcinomas (PGCs) are poorly characterized and studies focusing on this topic are rare due to their low incidence. The goal of this study is to analyze the therapeutic strategies, prognostic factors, and oncological outcomes of a series of patients with recurrent PGCs. PATIENTS AND METHODS Retrospective chart review (1997-2012) of patients with recurrent PGCs was initially treated with curative intent. RESULTS We identified 20 patients with recurrent PGCs. Eleven patients presented isolated local, regional, or distant metastases, while the rest had recurrences in multiple sites. Recurrent tumors tended to present more advanced T-stage (p = 0.01) and overall stage (p < 0.001), but not N-stage (p = 0.74) when compared to the initial tumors. Half the patients (50%) had distant metastases at the moment of recurrence diagnosis, and another three developed them after attempted salvage surgery. Only 8/20 patients with isolated local or regional recurrences were surgically salvaged with extended revision parotidectomy and neck dissection, respectively. The remaining 12 patients were managed on palliative basis. Overall survival (31.70 months vs. 20.73 months) and progression-free survival (28.70 months vs. 13.61 months) were not significantly different in patients managed surgically vs. palliatively. CONCLUSION Recurrent PGCs are aggressive neoplasms with a high rate of distant metastases. Surgical salvage can be considered in patients with limited local and/or regional recurrences. The alternative to surgical salvage is palliative management with different chemotherapeutic regimens. Survival does not differ between the two strategies in the present series.
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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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15
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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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16
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Thorpe LM, Schrock AB, Erlich RL, Miller VA, Knost J, Le-Lindqwister N, Jujjavarapu S, Ali SM, Liu JJ. Significant and durable clinical benefit from trastuzumab in 2 patients with HER2-amplified salivary gland cancer and a review of the literature. Head Neck 2016; 39:E40-E44. [PMID: 28006087 DOI: 10.1002/hed.24634] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/12/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Salivary ductal carcinoma and carcinoma ex pleomorphic adenoma (CEPA) are aggressive salivary gland cancers with poor prognosis. The standard of care is resection with or without radiotherapy, and there are no established systemic therapy options. METHODS We describe 1 patient with metastatic CEPA and 1 patient with metastatic recurrent salivary duct carcinoma whose tumors were evaluated by comprehensive genomic profiling. Testing identified human epidermal growth factor receptor 2 (HER2) amplification in both patients, and an additional activating HER2 mutation in the CEPA case. RESULTS Both patients were treated with the HER2-targeting monoclonal antibody trastuzumab (herceptin) plus chemotherapy and experienced rapid responses. Subsequently, both patients were given single-agent maintenance trastuzumab and continue to experience durable disease control. CONCLUSION Given the poor prognosis for salivary gland cancers and the limited treatment options upon recurrence or metastasis, patients should be tested for all classes of HER2 alterations. In cases with HER2 overexpression or activation, targeted therapies, such as trastuzumab are promising. © 2016 Wiley Periodicals, Inc. Head Neck 39: E40-E44, 2017.
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Affiliation(s)
| | | | | | | | | | | | | | - Siraj M Ali
- Foundation Medicine Inc, Cambridge, Massachusetts
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17
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Han J, Gu T, Yang X, Hu L, Xia R, Tian Z, Li J, Zhu L, Xu L, Zhang C. Primary intraosseous adenoid cystic carcinoma of the mandible: a comprehensive review and analysis of four new cases with emphasis on morphologic, immunophenotypic, and molecular characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:365-373. [PMID: 28094214 DOI: 10.1016/j.oooo.2016.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/21/2016] [Accepted: 11/01/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To comprehensively review the clinical manifestations, imaging, diagnosis, treatment, and pathologic features of primary intraosseous adenoid cystic carcinoma (PIACC) of the mandible and analyze PIACC histopathology and molecular features in four cases. STUDY DESIGN We reviewed the literature and retrospectively studied four cases of PIACC. RESULTS The clinical and imaging findings of PIACC are similar to other malignant or borderline-malignant mandible tumors. The four cases of PIACC included three males and one female (aged between 41 and 58 years). The histopathologic features of the tumors resembled those of ACC. We observed abundant osteoclasts resorbing bone at the leading edge of the tumors characterized by solid structure histology but not by the cribriform subtype. Additionally, all four cases showed abnormalities in the MYB gene and high expression of MYB protein. All patients survived for the duration of follow-up, and two patients had distant metastases (followed up for 3 to 36 months). CONCLUSIONS PIACC is extremely rare and is often clinically misdiagnosed. Different histologic subtypes could show different mechanisms of invasion of the mandible. MYB gene and protein expression abnormalities can be used as indicators for the precise diagnosis of PIACC.
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Affiliation(s)
- Jing Han
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Gu
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Yang
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Longwei Hu
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ronghui Xia
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Tian
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Li
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Zhu
- Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liqun Xu
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunye Zhang
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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18
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Staging and follow-up of high-grade malignant salivary gland tumours: The role of traditional versus functional imaging approaches – A review. Oral Oncol 2016; 60:157-66. [DOI: 10.1016/j.oraloncology.2016.04.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/19/2016] [Accepted: 04/28/2016] [Indexed: 02/08/2023]
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Yin LX, Ha PK. Genetic alterations in salivary gland cancers. Cancer 2016; 122:1822-31. [PMID: 26928905 DOI: 10.1002/cncr.29890] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 12/15/2015] [Accepted: 12/22/2015] [Indexed: 01/11/2023]
Abstract
Salivary gland cancers are an incredibly heterogeneous group of tumors that include 24 histologically distinct tumor types. The use of new genetic methods has paved the way for promising advancements in our understanding of the molecular biology underlying each type of tumor. The objective of this review was to highlight common oncogenes, tumor suppressor genes, and cytogenetic and epigenetic changes associated with the most common tumor types: mucoepidermoid carcinoma, adenoid cystic carcinoma, salivary duct carcinoma, mammary analogue secretory carcinoma, hyalinizing clear cell carcinoma, carcinoma ex pleomorphic adenoma, and acinic cell carcinoma. Recent insights into the pathogenesis of each cancer subtype have helped better define and classify these tumors. Further research in salivary gland cancers should focus on determining the key genes involved in the tumorigenesis of each distinct malignancy and identifying individualized chemotherapies directed at these targets. Cancer 2016;122:1822-31. © 2016 American Cancer Society.
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Affiliation(s)
- Linda X Yin
- Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Patrick K Ha
- Department of Otolaryngology, University of California San Francisco, San Francisco, California
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20
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Mochizuki D, Adams A, Warner KA, Zhang Z, Pearson AT, Misawa K, McLean SA, Wolf GT, Nör JE. Anti-tumor effect of inhibition of IL-6 signaling in mucoepidermoid carcinoma. Oncotarget 2015; 6:22822-35. [PMID: 26287605 PMCID: PMC4673202 DOI: 10.18632/oncotarget.4477] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 05/30/2015] [Indexed: 12/31/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is the most frequent malignant salivary gland cancer. Response to chemoradiotherapy is modest, and therefore radical surgery remains the standard-of-care. Emerging evidence suggests that Interleukin (IL)-6 signaling correlates with the survival of cancer stem cells and resistance to therapy. Here, we investigated whether inhibition of IL-6 receptor (IL-6R) signaling with tocilizumab (humanized anti-human IL-6R antibody) sensitizes MEC to chemotherapy using human mucoepidermoid carcinoma cell lines (UM-HMC) and correspondent xenograft models. In vitro, we observed that tocilizumab inhibited STAT3 phosphorylation but had no measurable effect in MEC cell viability (UM-HMC-1,-3A,-3B). In contrast, the anti-tumor effect of single agent tocilizumab on MEC xenografts was comparable to paclitaxel or cisplatin. Combination of tocilizumab with cisplatin or paclitaxel enhanced the inhibitory effect of chemotherapy on xenograft growth (P < 0.05), time to failure (P < 0.01), decreased vascular endothelial growth factor (VEGF) expression and tumor microvessel density (P < 0.05) without added systemic toxicities. Notably, tocilizumab decreased the fraction of MEC cancer stem cells (ALDH(high)CD44(high)) in vitro, and prevented paclitaxel-induced increase in the fraction of cancer stem cells in vivo (P < 0.05). Collectively, these findings demonstrate that tocilizumab enhances the anti-tumor effect of conventional chemotherapy in preclinical models of mucoepidermoid carcinoma, and suggest that patients might benefit from combination therapy with an inhibitor of IL-6R signaling and chemotherapeutic agent such as paclitaxel.
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Affiliation(s)
- Daiki Mochizuki
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Otolaryngology/Head Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - April Adams
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Kristy A. Warner
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Zhaocheng Zhang
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Alexander T. Pearson
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Kiyoshi Misawa
- Department of Otolaryngology/Head Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Scott A. McLean
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Gregory T. Wolf
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Jacques E. Nör
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Biomedical Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan, USA
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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21
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Aberrant Activation of the RANK Signaling Receptor Induces Murine Salivary Gland Tumors. PLoS One 2015; 10:e0128467. [PMID: 26061636 PMCID: PMC4464738 DOI: 10.1371/journal.pone.0128467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 04/27/2015] [Indexed: 12/21/2022] Open
Abstract
Unlike cancers of related exocrine tissues such as the mammary and prostate gland, diagnosis and treatment of aggressive salivary gland malignancies have not markedly advanced in decades. Effective clinical management of malignant salivary gland cancers is undercut by our limited knowledge concerning the key molecular signals that underpin the etiopathogenesis of this rare and heterogeneous head and neck cancer. Without knowledge of the critical signals that drive salivary gland tumorigenesis, tumor vulnerabilities cannot be exploited that allow for targeted molecular therapies. This knowledge insufficiency is further exacerbated by a paucity of preclinical mouse models (as compared to other cancer fields) with which to both study salivary gland pathobiology and test novel intervention strategies. Using a mouse transgenic approach, we demonstrate that deregulation of the Receptor Activator of NFkB Ligand (RANKL)/RANK signaling axis results in rapid tumor development in all three major salivary glands. In line with its established role in other exocrine gland cancers (i.e., breast cancer), the RANKL/RANK signaling axis elicits an aggressive salivary gland tumor phenotype both at the histologic and molecular level. Despite the ability of this cytokine signaling axis to drive advanced stage disease within a short latency period, early blockade of RANKL/RANK signaling markedly attenuates the development of malignant salivary gland neoplasms. Together, our findings have uncovered a tumorigenic role for RANKL/RANK in the salivary gland and suggest that targeting this pathway may represent a novel therapeutic intervention approach in the prevention and/or treatment of this understudied head and neck cancer.
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22
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Hemmat SM, Wang SJ, Uzelac A, Yom SS, Ryan WR. The Limitations of Routine Magnetic Resonance Imaging for Long-Term Post-Treatment Locoregional Surveillance of Salivary Carcinoma. ORL J Otorhinolaryngol Relat Spec 2015; 77:132-40. [PMID: 26022374 DOI: 10.1159/000381027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/16/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS To determine the utility of head and neck magnetic resonance imaging (HN-MRI) for the routine surveillance of patients without concurrent symptoms or signs of recurrence more than 6 months after treatment for salivary gland carcinoma (SGC). METHODS This is a retrospective single-institution review of SGC patients from 2000 to 2011 who underwent one or more HN-MRI scans without concurrent suspicious symptoms or signs of recurrence more than 6 months after the completion of treatment, with at least 6 months of follow-up after each scan. RESULTS Out of an original 283 SGC patients treated surgically, 41 patients, who were disease free 6 months after treatment, had undergone 96 routine HN-MRIs without concurrent suspicious symptoms or signs. Ten out of the 41 patients (24%) experienced a false-positive finding with routine HN-MRI. None of the 96 HN-MRIs demonstrated a true-positive or false-negative finding. CONCLUSION More than 6 months after treatment, routine HN-MRI for the detection of locoregional recurrence of SGC has a low utility in patients without concurrent suspicious symptoms or signs. While these data support the judicious use of routine HN-MRIs, the managing physician should ultimately decide on the best course of surveillance for an individual patient based on the unique risk factors and circumstances present.
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Affiliation(s)
- Shirin M Hemmat
- School of Medicine, San Francisco School of Medicine, University of California, San Francisco, Calif., USA
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Sepúlveda I, Platín E, Spencer ML, Mucientes P, Frelinghuysen M, Ortega P, Ulloa D. Oncocytoma of the parotid gland: a case report and review of the literature. Case Rep Oncol 2014; 7:109-16. [PMID: 24707257 PMCID: PMC3975758 DOI: 10.1159/000359998] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
We report the case of a patient who presented to the ENT service with left facial swelling of 5 months duration. Imaging studies revealed a dense expansive mass confined to the inside of the left deep parotid lobule and moderate enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of an oncocytoma. The patient was treated with total parotidectomy, complete tumor resection and sparing facial nerve surgery. Today, the patient is disease free and has no complications.
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Affiliation(s)
- Ilson Sepúlveda
- ENT-Head and Neck Surgery Service, General Hospital of Concepcion, Concepcion, Chile ; Department of Oral and Maxillofacial Radiology, Finis Terrae University School of Dentistry, Santiago, Chile
| | - Enrique Platín
- Department of Oral and Maxillofacial Radiology, University of North Carolina School of Dentistry, Chapel Hill, N.C., USA
| | | | | | | | - Pablo Ortega
- ENT-Head and Neck Surgery Service, General Hospital of Concepcion, Chile
| | - David Ulloa
- San Sebastian University, School of Medicine, Concepcion, Chile
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24
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Ohtomo R, Mori T, Shibata S, Tsuta K, Maeshima AM, Akazawa C, Watabe Y, Honda K, Yamada T, Yoshimoto S, Asai M, Okano H, Kanai Y, Tsuda H. SOX10 is a novel marker of acinus and intercalated duct differentiation in salivary gland tumors: a clue to the histogenesis for tumor diagnosis. Mod Pathol 2013; 26:1041-50. [PMID: 23558573 DOI: 10.1038/modpathol.2013.54] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/08/2013] [Accepted: 02/09/2013] [Indexed: 12/26/2022]
Abstract
Salivary gland tumors are relatively rare and morphologically diverse and heterogeneous tumors; therefore, histogenesis-based tumor markers are sorely needed to aid in diagnosing and determining the cell type of origin. SRY-related HMG-box 10 (SOX10) protein is a transcription factor known to be crucial in the specification of the neural crest and maintenance of Schwann cells and melanocytes. In addition, positive expression has also been implicated in the major salivary gland. Here, we examined SOX10 expression in various salivary gland tumors to correlate this expression with myoepithelial markers. Overall, 76 malignant and 14 benign tumors were examined. SOX10 expression clearly delineated two distinct subtypes of human salivary gland tumors; acinic cell carcinomas, adenoid cystic carcinomas, epithelial-myoepithelial carcinomas, myoepithelial carcinomas, and pleomorphic adenomas, including the pleomorphic adenoma component of carcinoma, were SOX10 positive, while salivary duct carcinomas, mucoepidermoid carcinomas, an oncocytic carcinoma, Oncocytomas, and Warthin tumors were SOX10 negative. Also, SOX10 was expressed in solid-type or non-specific morphology salivary gland tumors, but was not expressed in poorly differentiated squamous cell carcinomas. In normal human salivary gland tissue, SOX10 expression was specific to the nuclei of acini and both luminal and abluminal cells of intercalated ducts but not in other sites. Moreover, the murine model suggested that SOX10 continued to be expressed from the developmental stage to adulthood in the acinar and both luminal and abluminal intercalated ducts in the major salivary gland. Thus, SOX10 is a novel marker for diagnosing and understanding the histogenesis of salivary gland tumors.
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Affiliation(s)
- Rie Ohtomo
- Department of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan
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Digonnet A, Hamoir M, Andry G, Vander Poorten V, Haigentz M, Langendijk JA, de Bree R, Hinni ML, Mendenhall WM, Paleri V, Rinaldo A, Werner JA, Takes RP, Ferlito A. Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma. Eur Arch Otorhinolaryngol 2013; 270:1981-9. [PMID: 23100081 DOI: 10.1007/s00405-012-2220-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/30/2012] [Indexed: 01/05/2023]
Abstract
Post-therapy follow-up for patients with head and neck cancer other than upper aerodigestive tract squamous cell carcinoma should meet several objectives: to detect both local, regional or distant recurrences, to evaluate acute and long-term treatment-related side effects, to guide the rehabilitation process, and to provide psychosocial support when needed. To our knowledge, there are no published reports in the literature dedicated to the follow-up of patients with these tumours. A comprehensive literature search for post-treatment follow-up strategies spanning from 1980 to 2012 was performed on several databases. This review focuses on malignant salivary gland tumors, soft tissue sarcomas, cutaneous squamous cell carcinomas, and sinonasal adenocarcinomas. Given the varying biological behavior and treatment-related factors and based on the literature, different recommendations are made on the follow-up of patients with the above-mentioned tumors.
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Affiliation(s)
- Antoine Digonnet
- Department of Head and Neck and Thoracic Surgery, Institute Jules Bordet, Brussels, Belgium
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Adams A, Warner K, Nör JE. Salivary gland cancer stem cells. Oral Oncol 2013; 49:845-853. [PMID: 23810400 DOI: 10.1016/j.oraloncology.2013.05.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/22/2013] [Accepted: 05/31/2013] [Indexed: 12/13/2022]
Abstract
Emerging evidence suggests the existence of a tumorigenic population of cancer cells that demonstrate stem cell-like properties such as self-renewal and multipotency. These cells, termed cancer stem cells (CSC), are able to both initiate and maintain tumor formation and progression. Studies have shown that CSC are resistant to traditional chemotherapy treatments preventing complete eradication of the tumor cell population. Following treatment, CSC are able to re-initiate tumor growth leading to patient relapse. Salivary gland cancers are relatively rare but constitute a highly significant public health issue due to the lack of effective treatments. In particular, patients with mucoepidermoid carcinoma or adenoid cystic carcinoma, the two most common salivary malignancies, have low long-term survival rates due to the lack of response to current therapies. Considering the role of CSC in resistance to therapy in other tumor types, it is possible that this unique sub-population of cells is involved in resistance of salivary gland tumors to treatment. Characterization of CSC can lead to better understanding of the pathobiology of salivary gland malignancies as well as to the development of more effective therapies. Here, we make a brief overview of the state-of-the-science in salivary gland cancer, and discuss possible implications of the cancer stem cell hypothesis to the treatment of salivary gland malignancies.
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Affiliation(s)
- April Adams
- Department of Restorative Sciences, University of Michigan School of Dentistry, United States
| | - Kristy Warner
- Department of Restorative Sciences, University of Michigan School of Dentistry, United States
| | - Jacques E Nör
- Department of Restorative Sciences, University of Michigan School of Dentistry, United States; Department of Biomedical Engineering, University of Michigan College of Engineering, United States; Department of Otolaryngology, University of Michigan School of Medicine, United States.
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Cytomegalovirus-induced salivary gland pathology: AREG, FGF8, TNF-α, and IL-6 signal dysregulation and neoplasia. Exp Mol Pathol 2013; 94:386-97. [DOI: 10.1016/j.yexmp.2013.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 01/10/2013] [Accepted: 01/31/2013] [Indexed: 12/19/2022]
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Melnick M, Sedghizadeh PP, Deluca KA, Jaskoll T. Cytomegalovirus-induced salivary gland pathology: resistance to kinase inhibitors of the upregulated host cell EGFR/ERK pathway is associated with CMV-dependent stromal overexpression of IL-6 and fibronectin. HERPESVIRIDAE 2013; 4:1. [PMID: 23342981 PMCID: PMC3602079 DOI: 10.1186/2042-4280-4-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 12/28/2012] [Indexed: 11/10/2022]
Abstract
Background Recently we identified a relationship between human cytomegalovirus (hCMV) and human salivary gland (SG) mucoepidermoid carcinoma (MEC) in over 90% of cases; tumorigenesis in these cases uniformly correlated with active hCMV protein expression and an upregulation of the EGFR → ERK pathway. Our previously characterized, novel mouse organ culture model of mouse CMV (mCMV)-induced tumorigenesis displays a number of histologic and molecular characteristics similar to human MEC. Methods Newborn mouse submandibular glands (SMGs) were incubated with 1 × 105 PFU/ml of lacZ-tagged mCMV RM427+ on day 0 for 24 hours and then cultured in virus-free media for a total of 6 or 12 days with or without EGFR/ERK inhibitors and/or aciclovir. SMGs were collected for histology, immunolocalization (pERK, FN, IL-6), viral distribution, or Western blot analysis (pERK). Results Here we report: (1) mouse SMG tumors soon exhibit an acquired resistance to EGFR/ERK pathway kinase inhibitors, alone or in combination; (2) long term tumor regression can only be sustained by concurrent inhibitor and antiviral treatment; (3) CMV-dependent, kinase inhibitor resistance is associated with overexpression of fibronectin and IL-6 proteins in abnormal stromal cells. Conclusions Acquired resistance to kinase inhibitors is dependent upon CMV dysregulation of alternative pathways with downstream effectors common with the targeted pathway, a phenomenon with important therapeutic implications for human MEC of salivary glands.
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Affiliation(s)
- Michael Melnick
- Laboratory for Developmental Genetics, University of Southern California, 925 W 34th Street, MC-0641, Los Angeles, CA 90089-0641, USA.
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