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Kobayashi K, Saito Y, Kamogashira T, Kage H, Fukuoka O, Yamamura K, Mukai T, Oda K, Yamasoba T. Survival analysis of high-grade salivary gland carcinoma adjusted for length bias due to delay in comprehensive genomic profiling. Jpn J Clin Oncol 2023; 53:1092-1093. [PMID: 37781750 DOI: 10.1093/jjco/hyad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 10/03/2023] Open
Affiliation(s)
- Kenya Kobayashi
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
| | - Yuki Saito
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
| | - Teru Kamogashira
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
| | - Hidenori Kage
- Department of Next-Generation Precision Medicine Development Laboratory, The University of Tokyo, Tokyo, Japan
| | - Osamu Fukuoka
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
| | - Koji Yamamura
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
| | - Toshiyuki Mukai
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
| | - Katsutoshi Oda
- Department of Integrative Genomics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, Tokyo, Japan
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2
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Zhang D, Li L. Lymph node ratio-based prognostic model for risk stratification and individualized adjuvant therapy for postoperative major salivary duct carcinoma. Head Neck 2023. [PMID: 37114665 DOI: 10.1002/hed.27382] [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: 11/11/2022] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND To investigate the value of lymph node ratio (LNR) for postoperative major salivary duct carcinoma (MSDC) and to establish a model for prognosis assessment and treatment optimization. METHODS Data of MSDC were retrieved in public database, and prognostic factors were identified by univariate and multivariate analyses. A nomogram and risk stratification system were constructed. RESULTS Four hundred and eleven eligible patients were included (training cohort vs. validation cohort: 287: 124). LNR ≥0.09 was associated with worse overall survival (OS). Age at diagnosis, sex, T stage, and LNR were identified as prognostic factors and integrated into nomogram. Low-risk patients were found to have better OS than high-risk patients. Furthermore, postoperative radiotherapy (PORT) significantly improved OS in the high-risk subgroup, but chemotherapy did not confer a long-term survival benefit. CONCLUSIONS A nomogram model integrating LNR could better assess postoperative prognosis and risk stratification in MSDC, and identify patients who might benefit from PORT to avoid overtreatment.
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Affiliation(s)
- Di Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - 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, Beijing, China
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3
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Clinical value of adjuvant therapy on the prognosis of ductal carcinoma of the major salivary gland: a large-scale cohort study. Eur Arch Otorhinolaryngol 2023; 280:409-417. [PMID: 36036273 DOI: 10.1007/s00405-022-07599-x] [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: 05/02/2022] [Accepted: 08/05/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To explore the clinical characteristics, prognostic factors, and value of adjuvant therapy for major salivary duct carcinoma (SDC). METHODS Data of SDC patients who received surgery was obtained from Surveillance, Epidemiology, and End Results (SEER) database (2004-2016). Kaplan-Meier and Cox regression analyses were performed to assess prognostic factors. Propensity score matching (PSM) was done to evaluate the clinical value of adjuvant therapy. RESULTS A total of 287 patients were enrolled. The 5-year overall survival (OS) and disease-specific survival (DSS) rates were 53.8% and 70.8%, respectively. In the univariate analysis, tumor size, T, N, TNM staging, SEER combined staging, number of regional lymph nodes examined, and number of positive lymph nodes were associated with OS and DSS. Age and primary surgical methods were also related to OS. Among patients with negative lymph nodes, patients with tumor size > 4 cm had significantly worse prognosis (P = 0.009). Multivariate analysis showed that age > 75 years, T3-4, and positive lymph nodes were independent risk factors for SDC. After PSM, the prognostic factors were age, tumor site, and T and N stage. Postoperative radiotherapy could improve OS in patients with tumor size > 4 cm (P = 0.049). CONCLUSIONS Advanced age, submandibular gland lesions, T3-4 stage, and lymph node involvement were independent prognostic factors for SDC. In patients with tumors > 4 cm, adjuvant radiotherapy improved the OS of SDC patients.
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Kusafuka K, Sato Y, Nakatani E, Baba S, Maeda M, Yamanegi K, Ueda K, Inagaki H, Otsuki Y, Kuroda N, Suzuki K, Iwai H, Imamura Y, Itakura J, Yamanaka S, Takahashi H, Ito I, Akashi T, Daa T, Hamada M, Yasuda M, Kawata R, Yamamoto H, Tachibana Y, Fukuoka J, Muramatsu A, Arai K, Suzuki M. The implicated clinical factors for outcomes in 304 patients with salivary duct carcinoma: Multi-institutional retrospective analysis in Japan. Head Neck 2022; 44:1430-1441. [PMID: 35352425 PMCID: PMC9311811 DOI: 10.1002/hed.27034] [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: 02/20/2021] [Revised: 12/18/2021] [Accepted: 03/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background Salivary duct carcinoma (SDC) is a high‐grade salivary malignancy that frequently occurs as the carcinomatous component of carcinoma ex pleomorphic adenoma. We herein examined the clinical factors affecting outcomes in a large cohort of SDC. Methods We selected 304 SDC cases and investigated clinical characteristics and the factors affecting outcomes. Results The median age of the cases examined was 68 years, the most common primary site was the parotid gland (238 cases), and there was a male predominance (M/F = 5:1). Outcomes were significantly worse when the primary tumor site was the minor salivary glands (SG) than when it was the major SG. Outcomes were also significantly worse in pN(+) cases (161 cases) than in pN0 cases, particularly those with a metastatic lymph node number ≥11. The cumulative incidence of relapse and distant metastases was significantly higher in stage IV cases than in stage 0–III cases. Conclusions The absolute number of lymph node metastases, higher stages, and the minor SG as the primary tumor site were identified as factors affecting the outcome of SDC.
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Affiliation(s)
| | - Yoko Sato
- Division of Clinical Biostatistics, Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Eiji Nakatani
- Division of Clinical Biostatistics, Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Satoshi Baba
- Department of Diagnostic Pathology, Hamamatsu University School of Medicine Hospital, Shizuoka, Japan
| | - Matsuyoshi Maeda
- Department of Clinical Pathology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Koji Yamanegi
- Department of Pathology, Hyogo Medical College, Hyogo, Japan
| | - Kaori Ueda
- Department of Pathology and Molecular Diagnostics, Nagoya City University, Nagoya, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Nagoya City University, Nagoya, Japan
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kobe Koudou Hospital Center, Kobe, Japan
| | - Kensuke Suzuki
- Department of Otolaryngology - Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Hiroshi Iwai
- Department of Otolaryngology - Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Yoshiaki Imamura
- Division of Diagnostic Pathology/Surgical Pathology, University of Fukui Hospital, Fukui, Japan
| | - Junya Itakura
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Shoji Yamanaka
- Department of Diagnostic Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology - Head and Neck Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ichiro Ito
- Department of Diagnostic Pathology, Nagano Red Cross Hospital, Nagano, Japan
| | - Takumi Akashi
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Oita University, Oita, Japan
| | - Mei Hamada
- Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masanori Yasuda
- Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | | | - Yuri Tachibana
- Department of Pathology, Nagasaki University, Nagasaki, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University, Nagasaki, Japan
| | - Aya Muramatsu
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazumori Arai
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| | - Makoto Suzuki
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
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5
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Egal ESA, Scarini JF, de Lima-Souza RA, Lavareze L, Fernandes PM, Emerick C, Gonçalves MT, Helms MN, Altemani A, Mariano FV. Tumor microenvironment in salivary gland carcinomas: An orchestrated state of chaos. Oral Oncol 2022; 127:105777. [DOI: 10.1016/j.oraloncology.2022.105777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/01/2022] [Accepted: 02/13/2022] [Indexed: 12/14/2022]
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Ran J, Zou H, Li X, Guo F, Xu W, Han W. A population-based competing risk survival analysis of patients with salivary duct carcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1355. [PMID: 33313100 PMCID: PMC7723556 DOI: 10.21037/atm-20-1849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Salivary duct carcinoma (SDC) is a rare malignancy with high risk of local recurrence and distant metastases of the salivary gland. This study was designed to summarize the clinical and pathological features and to further evaluate them as potential prognostic factors for SDC in the salivary gland. Methods Clinical data of 266 patients diagnosed with SDC between 2004 and 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The prognostic factors affecting overall survival (OS) and cancer-specific survival (CSS) were determined by Kaplan-Meier analyses and Cox proportional hazards model. The nomogram was established to predict OS and CSS for SDC. The predictive accuracy of the nomograms was measured by concordance index (C-index). Results The 3- and 5-year OS of SDC patients were 67.41% and 47.86%, while the 3- and 5-year CSS were 84.6% and 60.7%, respectively. The primary site, T stage and M stage were identified as independent prognostic factors for OS by the multivariate analysis, whereas N stage, M stage, the presence of multiple primary carcinomas and the treatment modalities were identified as independent prognostic factors for CSS. The C-index values of the prognostic nomogram based the risk factors affecting SDC OS and CSS were 0.703 (0.646–0.760) and 0.771 (0.691–0.851), respectively. Conclusions SDC is an aggressive malignancy with a high proportion of advanced stage and lymph node metastases. Patients with increasing age, submandibular gland malignancy, advanced T stage, advanced N stage, advanced M stage, high lymph node ratio (LNR) and the presence of multiple primary carcinomas tend to have unfavorable outcomes. Radiotherapy or chemotherapy improve CSS remarkably. These factors will aid in effective therapeutic treatment modalities for SDC.
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Affiliation(s)
- Jianchuan Ran
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huihui Zou
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaoye Li
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Feng Guo
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenguang Xu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wei Han
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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7
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Yang ZY, Huang JH, Chen B, Xu CW, Lei L, Wang XJ, Fang MY. Efficacy of Pyrotinib in HER2-Overexpressing Salivary Duct Carcinoma With Lung Metastasis: A Case Report. Front Oncol 2020; 10:559057. [PMID: 33123470 PMCID: PMC7567027 DOI: 10.3389/fonc.2020.559057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/27/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Salivary duct carcinoma (SDC), an aggressive and rare malignancy with poor prognosis, is mostly associated with the overexpression of the androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2). However, limited data are available for the targeting of both HER2 and AR in advanced/metastatic SDC. Case Presentation: A 62-year-old man with advanced SDC accompanied by lung and lymph node metastasis showed disease progression after two lines of chemotherapy and endocrine therapy. Metastatic lesions from the lung biopsy were obtained, and immunohistochemistry (IHC) indicated the overexpression of AR and HER2 (3+). The patient was administered pyrotinib (a pan-ErbB receptor tyrosine kinase inhibitor) and bicalutamide (an androgen receptor antagonist) as a third-line treatment. During the ten months of follow-up, a durable partial response was achieved with this combination. Conclusions: This is the first clinical study to report the successful application of pyrotinib in a patient with advanced SDC. We recommend that pyrotinib and bicalutamide be used as salvage therapy for AR and HER2-positive advanced metastases in SDC, given the favorable response and clinical benefit.
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Affiliation(s)
- Zi-Yan Yang
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China.,Department of Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Jia-Huan Huang
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Bo Chen
- Department of Pathology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Chun-Wei Xu
- Department of Respiratory, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lei Lei
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Xiao-Jia Wang
- Department of Breast Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China
| | - Mei-Yu Fang
- Department of General Oncology, Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
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8
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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: 0.2] [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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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: 1.0] [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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Prognostic significance of lymphovascular invasion in patients with salivary duct cell carcinoma of the head and neck. Int J Oral Maxillofac Surg 2019; 49:693-699. [PMID: 31866144 DOI: 10.1016/j.ijom.2019.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/07/2019] [Accepted: 11/21/2019] [Indexed: 01/16/2023]
Abstract
The purpose of this study was to evaluate the treatment outcomes of patients who underwent surgery with curative intention after the diagnosis of salivary duct cell carcinoma (SDC) in the head and neck area and to analyse the prognostic factors and treatment failure pattern. Fifty-nine patients treated between March 2003 and December 2018 were enrolled in the study. The mean follow-up period was 45.5 months (range 12-189 months). The 5-year overall survival rate was 54.7% and the 5-year disease-free survival rate was 56.8%. Nineteen recurrences occurred during the study period: four loco-regional recurrences and 15 distant metastases. During the study period, 10 patients died of disease relapse and 5 patients died of other medical caused. On univariate analysis, lymphovascular invasion (LVI) (P=0.031) showed the most significant correlation with mortality. On multivariate Cox regression analysis, LVI showed the most significant correlation with patient survival (P = 0.027). LVI was the most significant prognostic factor related to the 5-year overall survival rate of SDC patients. The development of novel therapeutic agents is necessary to improve the survival rate of these patients with LVI.
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11
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Villepelet A, Lefèvre M, Verillaud B, Janot F, Garrel R, Vergez S, Bertolus C, Malard O, de Gabory L, Mauvais O, Baujat B. Salivary duct carcinoma: Prospective multicenter study of 61 cases of the Réseau d'Expertise Français des Cancers ORL Rares. Head Neck 2018; 41:584-591. [PMID: 30421824 DOI: 10.1002/hed.25194] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 01/08/2018] [Accepted: 03/02/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purposes of this study were to describe the characteristics of a prospective multicenter series of patients with salivary duct carcinoma and to investigate prognostic factors. METHODS Patients included for salivary duct carcinoma between 2009 and 2016 in the Réseau d'Expertise Français des Cancers ORL Rares (REFCOR) database were selected. Immunohistochemical analyses were performed. RESULTS Sixty-one patients were included in this study. The primary site was the parotid gland in 90% of the cases. Fifty-seven percent of the tumors were stage IV, 65% of patients had lymph node involvement, and 10% had metastases. Tumors showed androgen receptor (89%) and human epidermal growth factor receptor 2 (HER2)/neu (36%). Ninety-four percent of patients underwent surgery and 86% had postoperative radiotherapy. Six patients were treated with targeted therapies. The 3-year overall survival (OS) was 74% and the 3-year disease-free survival (DFS) was 44%. Tumor stages III to IV reduced DFS (hazard ratio [HR] 4.3; P = .04). The N2/3 class reduced distant metastasis-free survival (HR 7.3; P = .007). CONCLUSION Salivary duct carcinoma prognosis is poor and is correlated with tumor stage and lymph node classification. Androgen receptor and HER2/neu should be tested as they offer the possibility of targeted therapies.
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Affiliation(s)
- Aude Villepelet
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris / Université Pierre et Marie Curie, Paris, Paris, France
| | - Marine Lefèvre
- Service d'Anatomie Pathologique, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Benjamin Verillaud
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Janot
- Département d'ORL et de Chirurgie Cervicofaciale, Institut Gustave-Roussy, Villejuif, Paris, France
| | - Renaud Garrel
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Montpellier, Paris, France
| | - Sébastien Vergez
- Service d'ORL et de Chirurgie Cervicofaciale, IUC Toulouse, Paris, France
| | - Chloé Bertolus
- Service de Chirurgie Maxillofaciale, Hôpital Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Malard
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Nantes, Paris, France
| | - Ludovic de Gabory
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Bordeaux, Paris, France
| | - Olivier Mauvais
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Besançon, Paris, France
| | - Bertrand Baujat
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris / Université Pierre et Marie Curie, Paris, Paris, France
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- Réseau d'Expertise Français des Cancers ORL Rares: (REFCOR, French Rare Head and Neck Cancer Expert Network): S. Albert, G. Andry, E. Babin, C. Bach, J.-M. Badet, C. Badoual, A.C. Baglin, A. Banal, B. Barry, E. Baudin, B. Baujat, R.J. Bensadoun, C. Bertolus, J.-P. Bessède, D. Blanchard, C. Borel, A. Bozorg-Grayeli, R. Breheret, P. Breton, L. Brugel, G. Calais, O. Casiraghi, E. Cassagnau, L. Castillo, P. Ceruse, F. Chabolle, D. Chevalier, J.C. Chobaut, O. Choussy, A. Cosmidis, A. Coste, V. Costes, L. Crampette, V. Darrouzet, P. Demez, P. Dessi, B. Devauchelle, G. Dolivet, F. Dubrulle, S. Duflo, X. Dufour, S. Faivre, N. Fakhry, C. Ferron, F. Floret, L. de Gabory, R. Garrel, L. Geoffrois, L. Gilain, A. Giovanni, A. Girod, B. Guerrier, S. Hans, P. Herman, P. Hofman, M. Housset, R. Jankowski, F. Jegoux, M. Juliéron, M.-C. Kaminsky, F. Kolb, J. Lacau St Guily, L. Laccoureye, B. Lallemant, P. Lang, E. Lartigau, J.-P. Lavieille, M. Lefevre, X. Leroy, O. Malard, F. Massip, O. Mauvais, J.-C. Merol, J. Michel, T. Mom, S. Morinière, E. de Monès, G. Moulin, G. Noel, G. Poissonnet, J.-M. Prades, D. de Raucourt, E. Reyt, C. Righini, Y. Marie Robin, F. Rolland, B. Ruhin, N. Sarroul, P. Schultz, E. Serrano, O. Sterkers, V. Strunski, A. Sudaka, M. Tassart, S. Testelin, J. Thariat, A. Timochenko, B. Toussaint, E. Uro Coste, G. Valette, T. Van den Abbeele, A. Varoquaux, F. Veillon, S. Vergez, M. Wassef
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12
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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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13
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Beck AJCC, Lohuis PJFM, Al-Mamgani A, Smit LA, Klop WMC. Salivary duct carcinoma: evaluation of treatment and outcome in a tertiary referral institute. Eur Arch Otorhinolaryngol 2018; 275:1885-1892. [PMID: 29785551 DOI: 10.1007/s00405-018-5000-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/14/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE The aggressive behavior of salivary duct carcinoma (SDC) necessitates an aggressive treatment strategy, including surgery and radiotherapy (RT). We evaluated practice patterns and treatment outcomes in patients with SDC treated in our Institute. METHODS Patients with SDC of the parotid or submandibular gland treated with curative intention in our Institute from 1998 until 2016 were reviewed. Our diagnostic workup and treatment strategy were evaluated together with treatment outcomes. RESULTS Fifteen patients with SDC were included. Staging included MRI and ultrasound-guided fine needle aspiration cytology. Only in a minority (20%) of patients, the preoperative diagnosis of SDC was raised due to positive immunohistochemical staining for the androgen receptor (AR) on cytology. All patients were treated with (sub)total resection of the salivary gland and 53% underwent a therapeutic neck dissection. All patients except one received postoperative RT. Immunohistochemical staining was found positive for AR (100%) and human epidermal growth factor receptor 2 (HER2/neu) (13%). No local recurrences occurred. Regional and distant failure rates were 20% and 40%, respectively. CONCLUSIONS Excellent local control rates can be achieved with extensive (local) surgical treatment and postoperative RT. In case of lymph node metastases, a neck dissection with adjuvant postoperative RT is warranted. In patients with node-negative disease, a less aggressive approach for the neck seems feasible to reduce treatment-related morbidity.
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Affiliation(s)
- Ann-Jean C C Beck
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Peter J F M Lohuis
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | | | - Laura A Smit
- Department of Pathology, NKI-AVL, Amsterdam, The Netherlands
| | - Willem M C Klop
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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14
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Schmitt NC, Kang H, Sharma A. Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy. Oral Oncol 2017; 74:40-48. [PMID: 29103750 PMCID: PMC5685667 DOI: 10.1016/j.oraloncology.2017.09.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/16/2017] [Accepted: 09/12/2017] [Indexed: 12/15/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare, aggressive salivary malignancy that is often diagnosed at an advanced stage. Previously, little was known about outcomes of this disease due to its rarity. In the past several years, much has been learned about salivary duct carcinoma after publication of outcomes from several large single-institution series and national database searches. Recent studies of genomic alterations have helped elucidate the biology and pathogenesis of this aggressive disease. Here we review outcomes of the disease, effects of treatment, prognostic factors, and genomic alterations in SDC. Studies of targeted therapy and promising future directions are also discussed.
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Affiliation(s)
- Nicole C Schmitt
- Integrative Therapeutics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, United States; Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Bethesda, MD, United States.
| | - Hyunseok Kang
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Arun Sharma
- Division of Otolaryngology - Head and Neck Surgery, Southern Illinois University, Springfield, IL, United States
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15
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Aro K, Tarkkanen J, Saat R, Saarilahti K, Mäkitie A, Atula T. Submandibular gland cancer: Specific features and treatment considerations. Head Neck 2017; 40:154-162. [PMID: 29083518 DOI: 10.1002/hed.24981] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/15/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In the absence of unified treatment protocol, we evaluated the management and outcomes of submandibular gland cancers in an unselected patient series. METHODS We included all patients with resected submandibular gland cancer treated at the Helsinki University Hospital from 2000 to 2010 with a 5-year minimum follow-up. RESULTS Twenty-five patients with cancer represented 30% of submandibular gland neoplasms, and most were adenoid cystic carcinomas (ACCs; 56%). At presentation, 3 patients showed clinical signs of probable malignancy. Of 22 neck dissection specimens, 5 patients (20%) had metastases with an occult metastasis rate of 4%. Cancer recurred in 11 patients (44%), of which 7 (28%) were only at a distant site. The 5-year disease-specific survival (DSS) and overall survival (OS) rates were 76%, and disease-free survival (DFS) was 68%. CONCLUSION Most tumors were ACCs differing from the histological pattern of parotid gland cancers. Occult metastases were rare. The rarity of submandibular gland cancer, its variable histological pattern, and varying biological behavior warrant centralized management.
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Affiliation(s)
- Katri Aro
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Jussi Tarkkanen
- Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riste Saat
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kauko Saarilahti
- Department of Radiation Oncology, HUS Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Atula
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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16
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Margin Analysis: Malignant Salivary Gland Neoplasms of the Head and Neck. Oral Maxillofac Surg Clin North Am 2017; 29:315-324. [PMID: 28551337 DOI: 10.1016/j.coms.2017.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There are no established protocols for the optimum surgical margin required for salivary gland malignancies. Factors including histologic diagnosis and TNM stage have been shown to be important in prognosis and survival outcome and mandate special consideration of margin size. Salivary cancers are treated differently at different anatomic sites, and different histologic types show a propensity for major or minor glands. Low-grade malignancies are treated with soft tissue margins of 1 cm or less. The facial nerve is preserved unless infiltrated and encased. Adenoid cystic carcinoma and carcinoma ex pleomorphic adenoma require more complex planning to obtain negative margins.
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