1
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Zhang D, Li L. Prognostic models for estimating survival of salivary duct carcinoma: a population-based study. Eur Arch Otorhinolaryngol 2023; 280:1939-1954. [PMID: 36422671 DOI: 10.1007/s00405-022-07755-3] [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: 10/05/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE In a large salivary duct carcinoma (SDC) cohort, we aimed to investigate the clinical factors influencing their survival outcomes and to further establish prognostic models. METHODS Data of patients with SDC were extracted from the Surveillance, Epidemiology, and End Results database (1975-2019). A retrospective analysis was conducted to explore the prognostic factors on overall survival (OS) and disease-specific survival (DSS), and corresponding nomograms were established. RESULTS A steady upward trend in the incidence of SDC was observed over the past four decades. Totally, 399 patients (280 in the training set and 199 in the testing set) were enrolled. Advanced T stage, lymph node metastasis, distant metastasis, and surgery were associated with favorable OS and DSS. Besides, age > 80 years exhibited worse OS. The selected variables above were used to construct nomograms and online web calculators that could accurately predict patient survival. In addition, risk stratification systems were generated to identify low- and high-risk patients. As the risk level increased, the risk of both patient mortality and disease-specific mortality increased. CONCLUSIONS The SDC incidence was low, but steadily increasing. The proposed prognostic models provided a robust and efficient approach to predict survival and risk stratification in SDC patients.
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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, Chaoyang District, Panjiayuan nanli No.17, Beijing, 100021, China
| | - Lixi Li
- 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, Chaoyang District, Panjiayuan nanli No.17, Beijing, 100021, China.
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2
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A new approach to breast cancer terminology based on the anatomic site of tumour origin: The importance of radiologic imaging biomarkers. Eur J Radiol 2022; 149:110189. [DOI: 10.1016/j.ejrad.2022.110189] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/25/2022] [Indexed: 12/29/2022]
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3
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Meyer MT, Watermann C, Dreyer T, Wagner S, Wittekindt C, Klussmann JP, Ergün S, Baumgart-Vogt E, Karnati S. Differential Expression of Peroxisomal Proteins in Distinct Types of Parotid Gland Tumors. Int J Mol Sci 2021; 22:7872. [PMID: 34360635 PMCID: PMC8345988 DOI: 10.3390/ijms22157872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/08/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022] Open
Abstract
Salivary gland cancers are rare but aggressive tumors that have poor prognosis and lack effective cure. Of those, parotid tumors constitute the majority. Functioning as metabolic machinery contributing to cellular redox balance, peroxisomes have emerged as crucial players in tumorigenesis. Studies on murine and human cells have examined the role of peroxisomes in carcinogenesis with conflicting results. These studies either examined the consequences of altered peroxisomal proliferators or compared their expression in healthy and neoplastic tissues. None, however, examined such differences exclusively in human parotid tissue or extended comparison to peroxisomal proteins and their associated gene expressions. Therefore, we examined differences in peroxisomal dynamics in parotid tumors of different morphologies. Using immunofluorescence and quantitative PCR, we compared the expression levels of key peroxisomal enzymes and proliferators in healthy and neoplastic parotid tissue samples. Three parotid tumor subtypes were examined: pleomorphic adenoma, mucoepidermoid carcinoma and acinic cell carcinoma. We observed higher expression of peroxisomal matrix proteins in neoplastic samples with exceptional down regulation of certain enzymes; however, the degree of expression varied between tumor subtypes. Our findings confirm previous experimental results on other organ tissues and suggest peroxisomes as possible therapeutic targets or markers in all or certain subtypes of parotid neoplasms.
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Affiliation(s)
- Malin Tordis Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, Ebene-1, D-35392 Gießen, Germany; (M.T.M.); (C.W.); (S.W.); (C.W.); (J.P.K.)
| | - Christoph Watermann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, Ebene-1, D-35392 Gießen, Germany; (M.T.M.); (C.W.); (S.W.); (C.W.); (J.P.K.)
| | - Thomas Dreyer
- Institute of Pathology, Justus Liebig University, Langhansstrasse 10, D-35392 Gießen, Germany;
| | - Steffen Wagner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, Ebene-1, D-35392 Gießen, Germany; (M.T.M.); (C.W.); (S.W.); (C.W.); (J.P.K.)
| | - Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, Ebene-1, D-35392 Gießen, Germany; (M.T.M.); (C.W.); (S.W.); (C.W.); (J.P.K.)
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, Ebene-1, D-35392 Gießen, Germany; (M.T.M.); (C.W.); (S.W.); (C.W.); (J.P.K.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, D-50931 Cologne, Germany
| | - Süleyman Ergün
- Institute for Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Koellikerstrasse 6, D-97070 Würzburg, Germany;
| | - Eveline Baumgart-Vogt
- Institute for Anatomy and Cell Biology II, Medical Cell Biology, Justus Liebig University, D-35385 Gießen, Germany;
| | - Srikanth Karnati
- Institute for Anatomy and Cell Biology, Julius-Maximilians-University Würzburg, Koellikerstrasse 6, D-97070 Würzburg, Germany;
- Institute for Anatomy and Cell Biology II, Medical Cell Biology, Justus Liebig University, D-35385 Gießen, Germany;
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4
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Chen SL, Yeh CJ, Chan KC. Salivary Duct Carcinoma in the External Auditory Canal Causing Ipsilateral Hearing Loss. Diagnostics (Basel) 2021; 11:diagnostics11081312. [PMID: 34441247 PMCID: PMC8391587 DOI: 10.3390/diagnostics11081312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Salivary duct carcinoma (SDC) is a rare aggressive tumor. Most tumors are not confined to the salivary ducts; rather, they invade the major and minor salivary glands. Only a few case reports on such tumors in other primary sites have appeared. Case presentation: A 40-year-old male complained of right hearing loss (a common condition), but we made an extremely rare diagnosis of an SDC in the external auditory canal (EAC). EAC cancers are frequently misdiagnosed. In our patient, the otoscope revealed a smooth, bulging subcutaneous lesion with a non-epithelial defect suggestive of a benign lesion. However, an SDC of the EAC was confirmed through pathological and immunohistochemical analysis. Conclusions: We suggest detailed evaluation of even smooth EAC subcutaneous lesions to avoid erroneous diagnoses. To the best of our knowledge, this is the first report of SDC in the EAC.
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Affiliation(s)
- Shih-Lung Chen
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 333, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chi-Ju Yeh
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Pathology, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Kai-Chieh Chan
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou 333, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou 333, Taiwan
- Correspondence: ; Tel./Fax: +886-3-3979361
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5
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Baldassarre BM, Penner F, Bertero L, Di Perna G, Ajello M, Marengo N, Zenga F, Garbossa D. Solitary late spinal metastasis from apocrine salivary duct carcinoma: Case report. Surg Neurol Int 2021; 12:122. [PMID: 33880227 PMCID: PMC8053463 DOI: 10.25259/sni_903_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/19/2021] [Indexed: 11/04/2022] Open
Abstract
Background The salivary duct carcinomas (SDCs) are rare, high-grade neoplasms involving major salivary glands. Parotid is the most frequently involved gland (85%). Apocrine phenotype (histological presence of decapitation secretions) and androgen reception expression define SDC. The clinical course of these tumors is characterized by aggressive local behavior with extraglandular extension, high recurrence rates, early metastases, and poor prognoses. Despite aggressive surgical/radiation therapy management, the rates of locoregional and metastatic relapses are high, and the mortality rates over 48 months approach 65%. Notably, there is no treatment algorithm available for managing vertebral metastases from apocrine SDC. Case Description An elderly male presented with MR/CT findings of an isolated T11 vertebral metastasis attributed to a previously treated parotid SDC. On both CT/MR, it was an osteolytic lesion and demonstrated spinal canal infiltration. The patient underwent surgical biopsy/decompression/resection, following which the lesion histopathologically proved to be a SDC. The patient was subsequently treated with 30 Gy in 10 fractions within 2 weeks of discharge. One-month later, the MRI confirmed adequate epidural decompression without recurrence, and 9 months post-operatively, patient remained disease free. Conclusion Isolated metastasis attributed to parotid SDC followed by radiation therapy may result in tumor control.
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Affiliation(s)
| | - Federica Penner
- Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy
| | - Luca Bertero
- Department of Pathologic, Città Della Scienza e Della Salute, Turin, Italy
| | - Giuseppe Di Perna
- Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy
| | - Marco Ajello
- Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy
| | - Nicola Marengo
- Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy
| | - Francesco Zenga
- Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy
| | - Diego Garbossa
- Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy
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6
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Theocharis S, Tasoulas J, Masaoutis C, Kokkali S, Klijanienko J. Salivary gland cancer in the era of immunotherapy: can we exploit tumor microenvironment? Expert Opin Ther Targets 2020; 24:1047-1059. [PMID: 32744127 DOI: 10.1080/14728222.2020.1804863] [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] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Salivary gland cancers (SGCs) consist of a rare family of neoplasms with varying histology and biological behavior. Therapeutic regimens have been relatively unchanged for decades. The recent successes of immunotherapy have raised hopes for the development of more effective strategies in SGC, thus emphasizing the role of tumor microenvironment (TME) in the design for more effective therapies. AREAS COVERED This review presents an overview of the current knowledge on the pathobiology of SGC TME and discusses the potential of immunotherapeutic targeting. EXPERT OPINION Most data on the role of TME in SGC carcinogenesis are derived from preclinical studies. Signaling cascades of immunotherapeutic interest, PD-1/PD-L1 and PD-1/PD-L2, are active in many SGCs and might be associated with biological behavior and prognosis. Immunotherapeutic attempts are very limited, but recent findings in other tumors on the role of exosomes and PD-L2 signaling suggest that TME of SGCs warrants further research, emphasizing larger cohorts, histology-based stratification, and standardized evaluation of immunomodulatory molecules, to explore the potential of targeting tumor stroma and its signaling cascades. Furthermore, combination of immunotherapies or immunotherapies with the antineoplastic agents targeting AR, HER2, and tyrosine kinases, recently introduced in SGC treatment, constitutes a promising approach for the future.
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Affiliation(s)
- Stamatios Theocharis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens , Athens, Greece.,Department of Pathology, Institut Curie , Paris, France
| | - Jason Tasoulas
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens , Athens, Greece
| | - Christos Masaoutis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens , Athens, Greece
| | - Stefania Kokkali
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens , Athens, Greece.,First Medical Oncology Clinic, Saint-Savvas Anticancer Hospital , Athens, Greece
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Enomoto T, Aoki M, Miyagawa K, Matsumoto J, Kobayashi H, Takeuchi T, Abe H, Nonaka M, Sakata T, Inoue T, Nabeshima K. A Case of Salivary Duct Carcinoma Intracranial Invasion due to Perineural Invasion Through the Facial Nerve. World Neurosurg 2020; 140:332-337. [PMID: 32473330 DOI: 10.1016/j.wneu.2020.05.180] [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: 03/24/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is a rare parotid tumor that often develops as a rapidly growing mass with a poor prognosis. It has a high rate of distant metastases, sometimes with infiltration along nerves. We describe a case of SDC that originated outside the cranium and extended into the cranium along the path of the facial nerve. CASE DESCRIPTION A 74-year-old man underwent magnetic resonance imaging at a local hospital, which revealed a tumor in the left internal acoustic canal; the patient was referred to our department. A left facial schwannoma was suspected, and magnetic resonance imaging was performed again 6 months later. Rapid tumor growth was confirmed, and the tumor was resected. The tumor displayed atypical epithelial cells with comedo necrosis and cribriform structure and was diagnosed as SDC. All residual intracranial tumors were removed using the middle fossa approach. The tumor, which was considered to be a primary tumor, was found near the stylomastoid foramen, and it was removed with the parotid gland. Five months after the initial surgery, metastasis to the trigeminal nerve was observed, and this was removed using a retrosigmoid approach, followed by radiation therapy. CONCLUSIONS All 4 surgical specimens of this case were presented, and the path of tumor progression was examined in detail. Although the primary lesion was small, intracranial invasion along the facial nerve occurred. SDC should be considered as a tumor that can extend into the cranium, even with a small primary lesion.
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Affiliation(s)
- Toshiyuki Enomoto
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine Fukuoka University, Fukuoka, Japan.
| | - Ken Miyagawa
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Juntaro Matsumoto
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Hiromasa Kobayashi
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Toranoshin Takeuchi
- Department of Otolaryngology, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Hiroshi Abe
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Masani Nonaka
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Toshifumi Sakata
- Department of Otolaryngology, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Tooru Inoue
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine Fukuoka University, Fukuoka, Japan
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8
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Lee DS, Lee CG, Keum KC, Chung SY, Kim T, Wu HG, Kim JH, Sung MW, Ahn SH, Cho KH, Kang KM, Oh YT, Kim JH, Kang MK. Treatment outcomes of patients with salivary duct carcinoma undergoing surgery and postoperative radiotherapy. Acta Oncol 2020; 59:565-568. [PMID: 32085682 DOI: 10.1080/0284186x.2020.1730005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Dong Soo Lee
- Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Geol Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ki Chang Keum
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Yeun Chung
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Taehyung Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
- Cancer Research Institution, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Myung-Whun Sung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwan Ho Cho
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Jinju, South Korea
| | - Young-Taek Oh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Jin Hee Kim
- Department of Radiation Oncology, Keimyung University, School of Medicine, Daegu, South Korea
| | - Min Kyu Kang
- Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, South Korea
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9
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Adeberg S, Windisch P, Ehret F, Baur M, Akbaba S, Held T, Bernhardt D, Haefner MF, Krauss J, Kargus S, Freudlsperger C, Plinkert P, Flechtenmacher C, Herfarth K, Debus J, Rieken S. Intensity Modulated Radiotherapy (IMRT) With Carbon Ion Boost in the Multimodal Treatment of Salivary Duct Carcinoma. Front Oncol 2019; 9:1420. [PMID: 31921675 PMCID: PMC6932999 DOI: 10.3389/fonc.2019.01420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022] Open
Abstract
Background: To assess outcomes and treatment related toxicity following intensity-modulated radiotherapy (IMRT) and a Carbon Ion Radiotherapy (CIRT) boost for salivary duct carcinoma (SDC). Methods: Twenty-eight consecutive patients with SDC who underwent a postoperative (82%) or definitive (18%) radiation therapy between 2010 and 2017 were assessed in this retrospective single-center analysis. CIRT boost was delivered with median 18 Gy(RBE) in 6 daily fractions, followed by an TomoTherapy®-based IMRT (median 54 Gy in 27 daily fractions). Treatment-related acute toxicity was assessed according to CTCAE Version 4. Results: Tumors were most commonly located in the major salivary glands (n = 25; 89%); 23 patients (82%) received previous surgery (R0: 30%; R1: 57%; R2: 4%; RX: 19%). Median follow-up was 30 months. Four patients (14%) experienced a local relapse and 3 (11%) developed locoregional recurrence. The two-year local control (LC) and locoregional control (LRC) was 96 and 93%, respectively. Median disease-free survival (DFS) was 27 months, metastasis-free survival (MFS) was 69 months, and overall survival (OS) was 93 months. Acute grade 3 toxicity occurred in 11 patients (mucositis, dermatitis, xerostomia; n = 2 each (7%) were the most common) and 2 osteonecroses of the mandibular (grade 3) occurred. No patients experienced grade ≥4 toxicities. Conclusions: Multimodal therapy approaches with surgery followed by IMRT and CIRT boost for SDC leads to good local and locoregional disease control. However, the frequent occurrence of distant metastases limits the prognosis and requires optimization of adjuvant systemic therapies.
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Affiliation(s)
- Sebastian Adeberg
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
| | - Paul Windisch
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Ehret
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Melissa Baur
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sati Akbaba
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | - Thomas Held
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | - Denise Bernhardt
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | - Matthias F Haefner
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | | | - Steffen Kargus
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Plinkert
- Department of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
| | - Juergen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany.,National Center for Tumor Diseases, Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
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10
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Mitani Y, Lin SH, Pytynia KB, Ferrarotto R, El-Naggar AK. Reciprocal and Autonomous Glucocorticoid and Androgen Receptor Activation in Salivary Duct Carcinoma. Clin Cancer Res 2019; 26:1175-1184. [PMID: 31772120 DOI: 10.1158/1078-0432.ccr-19-1603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/01/2019] [Accepted: 11/22/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE To determine the expression of glucocorticoid receptor (GR) and androgen receptor (AR) in salivary duct carcinoma (SDC) and to analyze the role of these proteins in the development and management of this disease entity. EXPERIMENTAL DESIGN We performed a phenotypic assessment of GR and AR localization and expression, and determined their association with clinicopathologic factors in 67 primary SDCs. In vitro functional and response analysis of SDC cell lines was also performed. RESULTS Of the 67 primary tumors, 12 (18%) overexpressed GR protein, 30 (45%) had constitutive expression, and 25 (37%) had complete loss of expression. Reciprocal GR and AR expression was found in 32 (48%) tumors, concurrent constitutive GR and AR expression in 23 (34%), and simultaneous loss of both receptors and high GR with AR expressions were found in 12 (18%). GR overexpression was significantly associated with worse clinical outcomes. In vitro ligand-independent AR activation was observed in both male- and female-derived cell lines. GR antagonist treatment resulted in decreased cell proliferation and survival in GR-overexpressing cells, irrespective of AR status. Reciprocal GR- and AR-knockdown experiments revealed an independent interaction. CONCLUSIONS Our study, for the first time, demonstrates differential GR and AR expressions, autonomous GR and AR activation, and ligand-independent AR expression and activation in SDC cells. The findings provide critical information on the roles of GR and AR steroid receptors in SDC tumorigenesis and development of biomarkers to guide targeted steroid receptor therapy trials in patients with these tumors.
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Affiliation(s)
- Yoshitsugu Mitani
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sue-Hwa Lin
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristen B Pytynia
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Renata Ferrarotto
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adel K El-Naggar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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11
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Abstract
OBJECTIVE To describe salivary ductal carcinoma (SDC) presenting as an isolated lesion of the mastoid segment of the facial nerve PATIENTS:: A 70-year-old man presenting with weakness of his right lower lip that progressed to complete facial paralysis over a span of 2 weeks. MAIN OUTCOME MEASURES Clinical case records, immunohistochemical analyses, and radiological analyses including magnetic resonance imaging and positron emission tomography-computed tomography. RESULTS Nodular enhancement along the mastoid segment of the facial nerve was identified without any mass within the parotid on magnetic resonance imaging or regional/distant disease on positron emission tomography-computed tomography. Pathologic analysis of tissue obtained from a right parotidectomy, neck dissection, and transmastoid resection of the vertical segment of the facial nerve revealed a benign parotid gland with malignant glands identified intra- and perineurally within the central aspect of the gland. CONCLUSIONS SDC is one of the most aggressive salivary malignancies and typically presents as a rapidly enlarging mass in the involved gland. Although SDC's clinical course is characterized by early metastasis, isolated neural invasion has not been reported in the absence of an identifiable primary tumor within the gland of origin. The present case illustrates the clinical history and treatment of the first case of a SDC presenting as an isolated facial nerve lesion from perineural spread.
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12
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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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13
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Abstract
Salivary gland malignancies are rare tumors that comprise multiple histologic entities with diverse clinical behavior. Mucoepidermoid carcinoma is the most frequent primary salivary malignancy, followed by adenoid cystic and acinic cell carcinoma. Although most salivary malignancies are asymptomatic, presentation with a rapidly enlarging mass may be accompanied by pain, functional neurologic deficits, soft-tissue invasion, or nodal enlargement. Assessment of clinical behavior and physical exam greatly contributes to diagnostic workup. Preoperative imaging, to include ultrasound, computed tomography, or magnetic resonance imaging, may assist with surgical planning. Limitations of preoperative fine-needle aspiration cytology mean that, in some cases, definitive histologic diagnosis may not be established until therapeutic surgery is undertaken. Treatment strategies rely on oncologic resection of the primary site with negative margins as well as adjuvant radiotherapy in patients with high-risk features, such as high-grade histology, advanced T class, or perineural invasion. Regional lymphadenectomy is recommended for involved nodal basins. Patients with clinically node-negative disease at high risk for occult nodal metastases may be considered for elective lymphadenectomy or radiotherapy. Use of chemotherapy in the adjuvant setting, in combination with radiotherapy, remains controversial. The rate of objective response to palliative chemotherapy in recurrent or metastatic salivary gland malignancy remains low. In studies that include a significant proportion of adenoid cystic carcinomas, whether disease stability represents an indolent disease process or the true effect of a therapeutic drug may be difficult to discern. Recognition of genetic alterations and protein expression unique to salivary malignancies presents exciting new opportunities for molecularly targeted therapy, although the response to molecularly targeted therapy in studies has been modest thus far.
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14
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Lv T, Wang Y, Wang X. Subgroups of parotid gland infiltrating ductal carcinoma benefit from postoperative radiotherapy: a population-based study. Future Oncol 2019; 15:885-895. [DOI: 10.2217/fon-2018-0495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: To analyze the prognostic factors and the impact of postoperative radiotherapy (PORT) in parotid gland infiltrating ductal carcinoma (IDC). Materials & methods: 252 patients diagnosed with parotid gland IDC were identified from the SEER database. Kaplan–Meier and Cox regression analysis was performed to evaluate the prognostic factors. Propensity score matching was applied then. Results: Multivariate analysis showed old age and chemotherapy were independent risk factors in parotid gland IDC. Subgroup analysis demonstrated that overall survival (OS) rate of the PORT group was significantly superior to that of the no radiotherapy group in the T3–4 subgroup (p = 0.049), N1 subgroup (p = 0.019) and Tumor, Node, Metastasis (TNM) III subgroup (p = 0.025). Conclusion: PORT improved survival of parotid gland IDC patients within T3–4, N1 and TNM III subgroups.
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Affiliation(s)
- Tao Lv
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, PR China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China
| | - Yujie Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, PR China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China
| | - Xiaoshen Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, PR China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China
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15
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Saintigny P, Mitani Y, Pytynia KB, Ferrarotto R, Roberts DB, Weber RS, Kies MS, Maity SN, Lin SH, El-Naggar AK. Frequent PTEN loss and differential HER2/PI3K signaling pathway alterations in salivary duct carcinoma: Implications for targeted therapy. Cancer 2018; 124:3693-3705. [PMID: 30289966 DOI: 10.1002/cncr.31600] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/23/2018] [Accepted: 05/23/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with advanced primary and recurrent salivary duct carcinoma (SDC), a rare and lethal malignancy, have limited therapeutic options. Novel small-molecule agents aimed at targeting critical signaling associated with SDC tumorigenesis may lead to new therapeutic options for patients with these tumors. The human epidermal growth factor receptor 2 (HER2)/phosphoinositide 3-kinase (PI3K) axis, an important oncogenic pathway, has been targeted for therapy in several solid tumors. Currently, little is known about the role and clinical implications of alterations of the HER2/PI3K pathway in patients with SDC. METHODS The authors investigated the clinicopathologic features, genetic alterations, and expression of key members of the HER2/PI3K pathway in 43 primary tumors and conducted in vitro functional and targeted drug-response analyses on cell lines derived from salivary epithelial carcinomas. RESULTS In primary tumors, loss of phosphatase and tensin homolog (PTEN) expression was identified in 22 of 43 tumors (51%), overexpression of HER2 was observed in 12 of 43 tumors (28%), and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations were identified in 12 of 43 tumors (28%). Phosphorylated protein kinase B (p-AKT) was highly expressed in most tumors. Most tumors (70%) displayed mutually exclusive alterations of PI3K members, whereas 8 tumors (19%) had 2 or more concurrent abnormalities. In vitro studies demonstrated a direct association between PTEN loss and PI3K pathway activation and evidence of response to combined PI3Kα and PI3Kβ and/or pan-PI3K inhibitors. CONCLUSIONS The current analyses reveal frequent PTEN loss and mutually exclusive alterations of key PI3K pathway members in SDC and demonstrate in vitro evidence of a response to pan-PI3K inhibitors. These results provide a framework for a biomarker-based substratification of patients with SDC in future targeted therapy. Cancer 2018;124:3523-32. © 2018 American Cancer Society.
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Affiliation(s)
- Pierre Saintigny
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France.,Department of Translational Research and Innovation, Centre Léon Bérard, Lyon, France.,Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Yoshitsugu Mitani
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristen B Pytynia
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Renata Ferrarotto
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dianna B Roberts
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Merrill S Kies
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sankar N Maity
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sue-Hwa Lin
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adel K El-Naggar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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16
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Abstract
PURPOSE OF REVIEW The review puts new information on geno- and phenotype of salivary duct carcinoma (SDC) in the perspective of the updated 2017 WHO classification. RECENT FINDINGS The proportion of SDC is increasing. This may be because of a true rise in incidence, but certainly to better diagnostic tests and changed WHO definitions. In this light, a substantial proportion of carcinoma expleomorphic adenoma is now attributed to the category of SDC. 'Low-grade SDC' and 'SDC in-situ' of the former WHO classification, are now named low-grade and high-grade intraductal carcinoma (IDC), respectively. Recent series quantify biologic aggressiveness: perineural growth, vascular invasion, and extracapsular extension in lymph node metastasis are each observed in two out of three patients with SDC. Most patients die within 3 years, but once 5-year disease-free survival is reached, further disease activity is exceptional. The typical molecular biological profile with high human epidermal growth factor receptor 2 and androgen receptor expression is increasingly successfully exploited in clinical trials for advanced SDC. SUMMARY The aggressive SDC is increasingly diagnosed. Despite intensive combined surgery and radiation therapy, many patients recur, for whom new bullets, targeting the molecular biological mechanisms, are the subject of ongoing clinical trials.
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17
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Badlani J, Gupta R, Balasubramanian D, Smith J, Luk P, Clark J. Primary salivary gland malignancies: a review of clinicopathological evolution, molecular mechanisms and management. ANZ J Surg 2017; 88:152-157. [DOI: 10.1111/ans.14201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/12/2017] [Accepted: 07/25/2017] [Indexed: 12/12/2022]
Affiliation(s)
- James Badlani
- Sydney Head and Neck Cancer Institute; Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Sydney New South Wales Australia
- Department of Oral and Maxillofacial Surgery; Gold Coast University Hospital; Gold Coast Queensland Australia
| | - Ruta Gupta
- Department of Pathology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
| | | | - Joel Smith
- Sydney Head and Neck Cancer Institute; Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Sydney New South Wales Australia
| | - Peter Luk
- Department of Pathology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Jonathan Clark
- Sydney Head and Neck Cancer Institute; Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Sydney New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
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18
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Vallabh N, Srinivasan V, Hughes D, Agbamu D. Salivary duct carcinoma arising from the inferior turbinate. J Surg Case Rep 2017; 2017:rjx090. [PMID: 28775834 PMCID: PMC5534007 DOI: 10.1093/jscr/rjx090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 07/11/2017] [Indexed: 02/03/2023] Open
Abstract
Salivary duct carcinoma (SDC) is an uncommon, aggressive tumour, which carries a poor prognosis. SDC affects the major salivary glands, usually occurring in the parotid gland. A 76-year-old male patient presented with right-sided nasal obstruction and rhinorrhoea. A polypoidal mass was seen in the right inferior turbinate mimicking a benign neoplasm. Histological examination following wide excision led to a diagnosis of SDC. There are no therapeutic guidelines and management is based on experience with SDC of the major salivary glands. Given the aggressive nature and poor prognosis of the disease, it is a rare but important differential to consider in patients with unilateral nasal mass.
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Affiliation(s)
- Nimisha Vallabh
- Ear, Nose and Throat Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
| | - Venkat Srinivasan
- Ear, Nose and Throat Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
| | - David Hughes
- Radiology Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
| | - David Agbamu
- Histopatholgy Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
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19
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Gilbert MR, Sharma A, Schmitt NC, Johnson JT, Ferris RL, Duvvuri U, Kim S. A 20-Year Review of 75 Cases of Salivary Duct Carcinoma. JAMA Otolaryngol Head Neck Surg 2017; 142:489-95. [PMID: 26939990 DOI: 10.1001/jamaoto.2015.3930] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. OBJECTIVE To review the University of Pittsburgh Medical Center's experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. DESIGN, SETTING, AND PARTICIPANTS This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution's Head and Neck Oncology Database for further clinical details. MAIN OUTCOMES AND MEASURES Primary outcome measures consisted of OS and DFS. RESULTS The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33-93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4.5 years, respectively). Although underpowered, multivariable analysis demonstrated significantly worse OS in patients with N2 and N3 disease (hazard ratio [HR] 8.42, 95% CI, 1.84-38.5) but did not show significantly worse DFS or OS for facial nerve sacrifice or extracapsular spread. There was no association between ERBB2 positivity and survival and no difference in survival between patients receiving radiation therapy vs radiation therapy plus chemotherapy. No patients had recurrence or distant metastasis after 5 disease-free years. CONCLUSIONS AND RELEVANCE Salivary duct carcinoma is an aggressive disease. A large number of cases in this review were carcinoma ex pleomorphic adenoma and had classic negative prognostic indicators, such as perineural invasion, vascular invasion, and extracapsular spread. ERBB2 positivity was not associated with any difference in survival. Facial nerve involvement appears to indicate worse prognosis, as does nodal stage higher than N1. Recurrence and metastasis after 5 years are rare.
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Affiliation(s)
- Mark R Gilbert
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Arun Sharma
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Southern Illinois University, Springfield
| | - Nicole C Schmitt
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, Baltimore, Maryland
| | - Jonas T Johnson
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert L Ferris
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Umamaheswar Duvvuri
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Seungwon Kim
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
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20
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Establishment and genomic characterization of primary salivary duct carcinoma cell line. Oral Oncol 2017; 69:108-114. [PMID: 28559013 DOI: 10.1016/j.oraloncology.2017.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/10/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To develop and characterize in vitro salivary duct carcinoma as a surrogate for functional studies. MATERIALS AND METHODS Cells were dispersed from tumor tissue fragments under sterile conditions in RPMI media. Disassociated cells were cultivated, immortalized with hTERT and propagated for more than 100 passages. Morphologic, linage, cytogenetic and genomic analyses were performed on different passages of cell line and primary tumor. Soft agar growth was performed. RESULTS Analysis of cytomorphologic features, growth characteristics and lineage specific markers expression confirmed the epithelial derivation and the neoplastic nature of the cell line. DNA STRs analysis showed identical match of both cell line and primary tumor. Cultivated cells expressed Androgen Receptor (AR), PTEN, and EFGR proteins and the AR-V7 isoform transcript. Comparative exome-sequencing identified common mutated genes in both cell line and primary tumor. In-vitro colony formation of late passages is established. CONCLUSION We report the development of the first human salivary duct carcinoma cell line (MDA-SDC-04) that retains critical biological and genomic features of the donor tumor.
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21
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Imaue S, Tomihara K, Hamashima T, Tomizawa G, Nomura K, Sasahara M, Noguchi M. Successful multimodal treatment of intraoral salivary duct carcinoma in a patient with multiple lymph node metastases: a case report. World J Surg Oncol 2017; 15:18. [PMID: 28073374 PMCID: PMC5223568 DOI: 10.1186/s12957-016-1090-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 12/23/2016] [Indexed: 12/04/2022] Open
Abstract
Background Salivary duct carcinoma (SDC) is a high-grade salivary gland malignancy that is associated with an aggressive clinical behavior and poor prognosis. Herein, we report on a long surviving case of SDC of the minor salivary gland with multiple lymph node metastases (LNMs). Case presentation An 83-year-old woman presented with a history of lymphadenopathy in the right side of the neck and recent onset and rapid growth of a mass in the right buccal region. Clinical examinations and biopsy findings were suggestive of a salivary gland malignant tumor with regional LNMs. The patient was treated with neoadjuvant chemotherapy. Tumor excision and ipsilateral radical neck dissection were performed, followed by adjuvant chemoradiotherapy. Postoperative histological examination revealed a tumor with irregular nests of atypical ductal epithelial cells, a cribriform growth pattern, and comedo-like central necrosis that lead to a final diagnosis of SDC. LNMs were observed in six lymph nodes of the right side of the neck. The patient underwent postoperative chemotherapy using single-agent cisplatin that was administered concurrently with radiotherapy (total, 65 Gy). There was no evidence of local recurrence or distant metastasis for >6 years. Conclusions Although available data on treatment modalities for SDC remain limited, multimodal therapy may contribute to improved clinical outcomes in patients with advanced intraoral SDC.
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Affiliation(s)
- Shuichi Imaue
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan
| | - Kei Tomihara
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
| | - Takeru Hamashima
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan
| | - Gakuto Tomizawa
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan
| | - Kuninori Nomura
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan
| | - Masakiyo Sasahara
- Department of Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan
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22
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Mifsud M, Sharma S, Leon M, Padhya T, Otto K, Caudell J. Salivary Duct Carcinoma of the Parotid: Outcomes with a Contemporary Multidisciplinary Treatment Approach. Otolaryngol Head Neck Surg 2016; 154:1041-6. [PMID: 26980918 DOI: 10.1177/0194599816636812] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Salivary duct carcinoma (SDC) is a rare and aggressive malignancy for which an optimal treatment algorithm is lacking. We endeavored to assess the current treatment outcomes for SDC with a multimodality treatment approach combining surgery with adjuvant radiotherapy ± concurrent chemotherapy. STUDY DESIGN Case series with chart review. SETTING A National Cancer Institute-designated comprehensive cancer center. SUBJECTS AND METHODS The clinical record of 17 patients with salivary duct carcinoma were analyzed to assess locoregional control, recurrence-free survival, and overall survival. RESULTS All SDC cases (n = 17) were managed with surgical resection, followed by adjuvant radiotherapy (47.1%) or concurrent chemotherapy and radiotherapy (52.9%). Median patient follow up was 37 months. An aggressive disease course was generally observed, with 3-year recurrence-free survival and overall survival of 34.4% and 35.5%, respectively. The majority of recurrences were distant. Intensification with adjuvant concurrent chemotherapy was not associated with improved outcomes on univariate survival analysis. CONCLUSION For salivary duct carcinoma, a multimodality treatment approach is associated with acceptable locoregional control rates but poor distant control and overall survival. Novel systemic therapies may be needed to optimize clinical outcomes.
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Affiliation(s)
- Matthew Mifsud
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Saurabh Sharma
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Marino Leon
- Department of Pathology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
| | - Tapan Padhya
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
| | - Kristen Otto
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jimmy Caudell
- Department of Radiation Oncology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
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23
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Abstract
Major salivary gland malignancies are a rare but histologically diverse group of entities. Establishing the diagnosis of a malignant salivary neoplasm may be challenging because of the often minimally symptomatic nature of the disease, and limitations of imaging modalities and cytology. Treatment is centered on surgical therapy and adjuvant radiation in selected scenarios. Systemic therapy with chemotherapeutic agents and monoclonal antibodies lacks evidence in support of its routine use.
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Affiliation(s)
- Aru Panwar
- Division of Head and Neck Surgery, University of Nebraska Medical Center, 600 S, 42nd Street, Omaha, NE 68198, USA.
| | - Jessica A Kozel
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - William M Lydiatt
- Division of Head and Neck Surgery, Nebraska Methodist Hospital, 8303 Dodge Street, Omaha, NE 68114, USA
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24
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Breinholt H, Elhakim MT, Godballe C, Andersen LJ, Primdahl H, Kristensen CA, Bjørndal K. Salivary duct carcinoma: a Danish national study. J Oral Pathol Med 2016; 45:664-671. [PMID: 26822194 DOI: 10.1111/jop.12426] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND To present the first national series of salivary duct carcinoma patients, including survival rates and an analysis of prognostic factors. METHODS By merging three Danish nationwide registries that encompass an entire population, 34 patients diagnosed with salivary duct carcinoma from 1990 to 2005 were identified. Histological slides were reviewed, and data concerning demographics, tumour site, clinical stage, treatment profiles and follow-up were retrieved. Survival estimates and prognostic factors were evaluated by comparing Kaplan-Meier plots using the Mantel-Haenszel log-rank test. RESULTS Salivary duct carcinoma showed an incidence of 0.04/100.000 inhabitants/year. Distant recurrence was seen in 52% of patients. Five-year overall survival, disease-specific survival and recurrence-free survival were 32%, 42% and 35%, respectively. Univariate analyses suggested that overall stage (III/IV) and vascular invasion have a negative impact on all survival measures. Involved resection margins correlated with a poorer overall survival and disease-specific survival, whereas adjuvant radiotherapy improved overall survival and recurrence-free survival. CONCLUSIONS Salivary duct carcinoma incidence averages to two episodes per year in the entire Kingdom of Denmark. With half of patients in this study experiencing distant recurrences and only a third surviving at 5 years, prognosis is dismal. Advanced overall stage, vascular invasion and involved resection margins all seem to correlate with a poorer survival, while adjuvant radiotherapy significantly improved outcome. Extensive T-site surgery, neck dissection and adjuvant radiotherapy are therefore recommended.
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Affiliation(s)
- Helle Breinholt
- Department of ORL - Head and Neck Surgery, Odense University Hospital, Odense, Denmark
| | | | - Christian Godballe
- Department of ORL - Head and Neck Surgery, Odense University Hospital, Odense, Denmark
| | | | - Hanne Primdahl
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Claus A Kristensen
- Department of Oncology, Copenhagen University Hospital/Rigshospitalet, Copenhagen, Denmark
| | - Kristine Bjørndal
- Department of ORL - Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
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25
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Salivary Duct Carcinoma of the Deep Lobe of the Parotid Gland: A Rare Clinical Finding. Arch Plast Surg 2016; 43:107-10. [PMID: 26848459 PMCID: PMC4738114 DOI: 10.5999/aps.2016.43.1.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 04/10/2015] [Accepted: 05/07/2015] [Indexed: 12/28/2022] Open
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26
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Luk PP, Weston JD, Yu B, Selinger CI, Ekmejian R, Eviston TJ, Lum T, Gao K, Boyer M, O'Toole SA, Clark JR, Gupta R. Salivary duct carcinoma: Clinicopathologic features, morphologic spectrum, and somatic mutations. Head Neck 2015; 38 Suppl 1:E1838-47. [PMID: 26699379 DOI: 10.1002/hed.24332] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Accurate diagnosis of salivary duct carcinoma requires a high index of suspicion and clinicopathologic correlation. Hallmark genetic changes that may provide novel therapeutic options are being explored. METHODS One hundred ninety salivary gland malignancies at Royal Prince Alfred Hospital (from 1989-2014) were reviewed. Human epidermal growth factor receptor 2 (HER2) and androgen receptor status were determined along with multigene profiling. RESULTS Twenty-three salivary duct carcinomas were identified, predominantly in men in their fifth to ninth decades of life. Facial nerve palsy (12%) and cervical lymph node metastases (82%) were present, and 96% received postoperative adjuvant therapy. Histologically, the tumors resembled high-grade invasive and in situ ductal carcinoma of the breast. Micropapillary, papillary, sarcomatoid, oncocytic, and mucinous variants were seen. The tumors showed androgen receptor (70%), HER2 amplification (30%), and HRAS, AKT1, PIK3CA, and NRAS mutations (22%; cumulative). The 5-year disease-free survival was 36%. CONCLUSION Salivary duct carcinoma demonstrates a wide histopathologic spectrum. Treatment strategies need to take androgen receptor, HER2 amplification, and PIK3CA mutation into account. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1838-E1847, 2016.
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Affiliation(s)
- Peter P Luk
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Bing Yu
- Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, Australia.,Central Clinical School, The University of Sydney, Australia
| | - Christina I Selinger
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | | | - Trina Lum
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Kan Gao
- The Sydney Head and Neck Cancer Institute, Australia
| | - Michael Boyer
- Central Clinical School, The University of Sydney, Australia.,The Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Sandra A O'Toole
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.,Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, Australia.,Central Clinical School, The University of Sydney, Australia
| | - Jonathan R Clark
- Central Clinical School, The University of Sydney, Australia.,The Sydney Head and Neck Cancer Institute, Australia.,The Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Ruta Gupta
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.,Central Clinical School, The University of Sydney, Australia
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27
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Schmitt NC, Sharma A, Gilbert MR, Kim S. Early T Stage Salivary Duct Carcinoma: Outcomes and Implications for Patient Counseling. Otolaryngol Head Neck Surg 2015; 153:795-8. [PMID: 26307577 DOI: 10.1177/0194599815601659] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/29/2015] [Indexed: 12/19/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare salivary malignancy that often presents at advanced stage. Outcomes of low T stage patients with SDC have not been previously examined in detail. We queried our institution's cancer database and identified 28 patients with SDC in situ or T1/T2 SDC. A retrospective chart review was performed, followed by comparison of clinicopathologic features with N stage, disease-free survival, and overall survival. Patients tended to be male, in their sixties, with a high incidence of regional metastases, as in prior reports. Five-year disease-free and overall survival were 49%. Median disease-free survival was 3.24 years, and overall survival was 4.65 years. Parotid location, vascular invasion, facial nerve sacrifice, and extracapsular extension were associated with worse survival. This study provides practical information for counseling of patients who undergo surgery for a parotid mass and are found to have this aggressive malignancy.
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Affiliation(s)
- Nicole C Schmitt
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arun Sharma
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University, Springfield, Illinois, USA
| | - Mark R Gilbert
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Seungwon Kim
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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28
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Eviston TJ, Yabe TE, Gupta R, Ebrahimi A, Clark JR. Parotidectomy: surgery in evolution. ANZ J Surg 2015; 86:193-9. [DOI: 10.1111/ans.13212] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Timothy J. Eviston
- Head and Neck Surgery; Chris O'Brien Lifehouse; Camperdown New South Wales Australia
- Prince of Wales Clinical School; University of New South Wales; Randwick New South Wales Australia
| | - Takako E. Yabe
- Head and Neck Surgery; Liverpool Hospital; Sydney New South Wales Australia
| | - Ruta Gupta
- Head and Neck Surgery; Chris O'Brien Lifehouse; Camperdown New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
| | - Ardalan Ebrahimi
- Head and Neck Surgery; Liverpool Hospital; Sydney New South Wales Australia
| | - Jonathan R. Clark
- Head and Neck Surgery; Chris O'Brien Lifehouse; Camperdown New South Wales Australia
- Prince of Wales Clinical School; University of New South Wales; Randwick New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
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29
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Salivary gland lesions: recent advances and evolving concepts. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:661-74. [DOI: 10.1016/j.oooo.2015.02.481] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 02/07/2015] [Accepted: 02/20/2015] [Indexed: 12/18/2022]
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30
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Huang X, Hao J, Chen S, Deng R. Salivary duct carcinoma: A clinopathological report of 11 cases. Oncol Lett 2015; 10:337-341. [PMID: 26171026 DOI: 10.3892/ol.2015.3176] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 01/13/2015] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to summarize the clinicopathological and immunohistochemical characteristics of salivary duct carcinoma (SDC) and to evaluate the currently available treatment modalities. Between 2001 and 2011, 11 patients with SDC were diagnosed and treated at the Affiliated Hospital of Stomatology of Nanjing University (Nanjing, Jiangsu, China). The present study retrospectively reviewed the clinicopathological and immunohistochemical data of these 11 patients and the results indicated that the parotid gland was the most commonly affected site, followed by the submandibular gland and the palate. Furthermore, the mean age of onset was 58.8 years and all cases were treated with surgery, with 72.7% receiving post-operative radiation therapy. The range for the follow-up period was 10-89 months and of the 11 patients investigated, only two succumbed to the disease. In addition, the two-year overall survival rate was 75% according to Kaplan-Meier analysis and the mean overall survival time was 72.8 months. In conclusion, the present study determined that the site of the malignancy is the best predictor of survival in patients with the rare salivary malignancy SDC, while age, gender, T stage, N stage, American Joint Committee on Cancer stage, nerve paralysis, post-operative radiation, neck dissection, and protein expression levels of Ki-67, androgen receptor and human epidermal growth factor-2/neu are less influential factors.
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Affiliation(s)
- Xiaofeng Huang
- Department of Pathology, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
| | - Jing Hao
- Central Laboratory, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
| | - Sheng Chen
- Department of Pathology, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
| | - Runzhi Deng
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
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31
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Magaki SD, Bhuta S, Abemayor E, Nabili V, Sepahdari AR, Lai CK. Carcinoma ex-pleomorphic adenoma of the parotid gland consisting of high-grade salivary duct carcinoma and keratinizing squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:e169-73. [PMID: 25782724 DOI: 10.1016/j.oooo.2015.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/18/2015] [Accepted: 01/25/2015] [Indexed: 10/24/2022]
Abstract
Carcinoma ex-pleomorphic adenoma (CXPA) is a rare salivary gland malignancy that presents diagnostic difficulties partly because of its wide range of histologic presentations. We report a case of a 77-year-old man, who presented with a 6-year history of a parotid mass that had undergone rapid growth within weeks. Magnetic resonance imaging revealed an infiltrative mass in the parotid gland, and the fine-needle aspiration (FNA) biopsy result was highly suspicious for carcinoma. Subsequent excision of the tumor demonstrated a poorly differentiated epithelial neoplasm consisting of keratinizing squamous cell carcinoma (SCC) and adenocarcinoma with regions of both ductal carcinoma in situ and invasive salivary duct carcinoma (SDC). Only focal areas exhibited a benign pleomorphic adenoma component. To our knowledge, this is the first case of a CXPA that consists of both a high-grade SDC and a keratinizing SCC in the parotid gland.
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Affiliation(s)
- Shino D Magaki
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA 90095, USA
| | - Sunita Bhuta
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA 90095, USA
| | - Elliot Abemayor
- Division of Head and Neck Surgery, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA 90095, USA
| | - Vishad Nabili
- Division of Head and Neck Surgery, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA 90095, USA
| | - Ali R Sepahdari
- Department of Radiological Sciences, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA 90095, USA
| | - Chi K Lai
- Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology, The Ottawa Hospital, Ottawa, Ontario K1H 8L6, Canada.
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32
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Shi S, Fang Q, Liu F, Zhong M, Sun C. Prognostic factors and survival rates for parotid duct carcinoma patients. J Craniomaxillofac Surg 2014; 42:1929-31. [DOI: 10.1016/j.jcms.2014.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 05/21/2014] [Accepted: 08/05/2014] [Indexed: 10/24/2022] Open
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Ku BM, Jung HA, Sun JM, Ko YH, Jeong HS, Son YI, Baek CH, Park K, Ahn MJ. High-throughput profiling identifies clinically actionable mutations in salivary duct carcinoma. J Transl Med 2014; 12:299. [PMID: 25343854 PMCID: PMC4216375 DOI: 10.1186/s12967-014-0299-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 10/14/2014] [Indexed: 12/17/2022] Open
Abstract
Background Salivary duct carcinoma (SDC) is a highly aggressive subtype of salivary gland cancers and there is no established standard therapy for this disease. Thus, development of molecular markers for SDC will be important to guide the diagnosis and therapy of this aggressive tumor. Methods We performed next-generation sequencing using the Ion Torrent AmpliSeq cancer panel, which explores the mutational status of hotspot regions in 50 cancer-associated genes, and we analyzed copy number variations (CNVs) of 21 genes by NanoString nCounter for 37 patients with SDC. Fluorescent in situ hybridization was also conducted to confirm ERBB2 gene amplification. Clinical records and tumor histopathology of the patients were retrospectively reviewed. Results Genetic alterations were detected in 29 of 37 (78.3%) tumors, including mutations in PIK3CA (N = 9, 24.3%), ERBB2 (N = 4, 10.8%), and EGFR (N = 4, 10.8%). To our knowledge, this is the first time that ERBB2 mutations have been reported in this tumor type. Both PIK3CA and ERBB2 mutation status were associated with poor overall survival, but without statistical significance. ERBB2 amplification was strong and common in SDC and almost all cases also exhibited EGFR and ERBB3 amplifications. Conclusions This study reports the largest and most comprehensive analysis of DNA aberrations in SDC. Our results show that PIK3CA and/or ERBB2 alterations in the development of SDC might be a useful diagnostic tool and could serve as a potential therapeutic target.
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Oncogenic PIK3CA mutation and dysregulation in human salivary duct carcinoma. BIOMED RESEARCH INTERNATIONAL 2014; 2014:810487. [PMID: 24511546 PMCID: PMC3910486 DOI: 10.1155/2014/810487] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/12/2013] [Accepted: 12/21/2013] [Indexed: 12/29/2022]
Abstract
Salivary duct carcinoma (SDC) is an aggressive malignant tumor with a high mortality, which resembles high-grade breast ductal carcinoma in morphology. The parotid gland is the most common location. Its molecular genetic characteristics remain largely unknown. We have previously reported high incidence of PIK3CA somatic mutations in head and neck squamous cell carcinoma, particularly in pharyngeal cancers. Here we examined the PIK3CA gene expression status and hotspot mutations in six cases of SDC by immunohistochemistry and genomic DNA sequencing. Immunohistochemistry showed that PIK3CA expression was elevated in all six patients with SDC. By DNA sequencing, two hotspot mutations of the PIK3CA gene, E545K (exon 9) and H1047R (exon 20), were identified in two of the six cases. Our results support that oncogenic PIK3CA is upregulated and frequently mutated in human SDC, adding evidence that PIK3CA oncogenic pathway is critical in the tumorigenesis of SDC, and may be a plausible drug target for this rare disease.
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35
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Golusiński W, Wegner A, Trzeciak P, Golusiński P, Sówka M, Kopczyński A, Bromboszcz M, Marszałek A. [The expression assessment of the estrogen, progesterone and HER2 receptors in selected malignant tumors of the salivary glands]. Otolaryngol Pol 2013; 67:245-51. [PMID: 24021827 DOI: 10.1016/j.otpol.2013.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/01/2013] [Accepted: 04/08/2013] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The incidence of the malignant tumors of the salivary glands is relatelively low. However, rapid locoregional progression, distant metastases occurrence and high local recurrence rate occurring despite radical surgical treatment, significantly affect the outcome. Malignant tumors of the salivary glands are characterized by low radiosensitivity and poor response to systemic therapy. Therefore there is a need for new targeted therapies which may improve the prognosis. In some aspects, malignant tumors of the salivary glands are similar to breast cancers. Efficacy of hormonal replacement therapy and the treatment with the monoclonal antibody (trastuzumab) in the treatment of breast cancer is well known and confirmed. Criterion determining the qualification for treatment is the presence of hormone receptors and HER2 receptors in the tumor. AIM The aim of this study was to evaluate the expression of estrogen receptor, progesterone receptor and HER2 in selected salivary gland malignancies. MATERIALS AND METHODS Study group consisted of 51 patients with the salivary glands cancer. In the study group there were 42 tumors in the parotid gland, 7 tumors of the submandibular gland, 1 in the mucosa of the cheek and 1 tumor in the tongue. Histologically material comprised of muco-epidermoid carcinoma (10), adenoid-cystic carcinoma (8), salivary duct (7), adenocarcinoma (6), squamous cell carcinoma (6), mioepithelial carcinoma (5) and other (9). In all cases immunohistochemical analysis of the estrogen receptor, progesterone receptor and HER2 receptor was performed. RESULTS The expression of the estrogen receptor was found in 18% of tumors (9 patients). The expression of the progesterone receptor was found in 20% (10 patients). HER2 expression was found in 10% of tumors and was related to only one histological type of tumor - salivary duct carcinoma. CONCLUSION HER2 expression in malignant tumors of the salivary glands, especially in salivary duct carcinoma may be of use in future implementation of new targeted therapies based on monoclonal antibodies.
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Affiliation(s)
- Wojciech Golusiński
- Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny im. Karola Marcinkowskiego, Kierownik: prof. dr hab. Wojciech Golusiński, Poznań, Poland; Wielkopolskie Centrum Onkologii im. Marii Skłodowskiej-Curie, Kierownik: prof. dr hab. Julian Malicki, Poznań, Poland
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36
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Nagao T, Sato E, Inoue R, Oshiro H, H. Takahashi R, Nagai T, Yoshida M, Suzuki F, Obikane H, Yamashina M, Matsubayashi J. Immunohistochemical analysis of salivary gland tumors: application for surgical pathology practice. Acta Histochem Cytochem 2012; 45:269-82. [PMID: 23209336 PMCID: PMC3496863 DOI: 10.1267/ahc.12019] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 07/04/2012] [Indexed: 01/05/2023] Open
Abstract
Salivary gland tumors are relatively uncommon and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants, in addition to overlapping histological patterns similar to those observed in different tumor entities. The classification is complex, but is closely relevant to the prognostic and therapeutic aspects. Although hematoxylin-eosin staining is still the gold standard method used for the diagnosis, immunohistochemistry (IHC) can enhance the accuracy and be a helpful tool when in cases to investigate the subjects that cannot be assessed by histological examination, such as the cell nature and differentiation status, cell proliferation, and tumor protein expression. This review depicts on the practical diagnostic utility of IHC in salivary gland tumor pathology under the following issues: assessment of cell differentiation, focusing on neoplastic myoepithelial cells; discrimination of histologically mimic tumor groups; diagnosis of specific tumor types, e.g., pleomorphic adenoma, adenoid cystic carcinoma, and salivary duct carcinoma; and evaluation of malignancy and prognostic factors. IHC plays a limited, even though important, role in the diagnosis of salivary gland tumors, but is often useful to support the histological assessment. However, unfortunately few tumor type-specific markers are still currently available. For these reasons, IHC should be considered a method that can be used to assist the final diagnosis, and its results themselves do not directly indicate a definitive diagnosis.
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Affiliation(s)
- Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Eiichi Sato
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Rie Inoue
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Hisashi Oshiro
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Reisuke H. Takahashi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Takeshi Nagai
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Maki Yoshida
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Fumie Suzuki
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Hiyo Obikane
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Mitsumasa Yamashina
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
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