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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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Dos Santos ES, Rodrigues-Fernandes CI, Speight PM, Khurram SA, Alsanie I, Costa Normando AG, Prado-Ribeiro AC, Brandão TB, Kowalski LP, Silva Guerra EN, Lopes MA, Vargas PA, Santos-Silva AR, Leme AFP. Impact of tumor site on the prognosis of salivary gland neoplasms: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 162:103352. [PMID: 33991662 DOI: 10.1016/j.critrevonc.2021.103352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/28/2021] [Accepted: 05/08/2021] [Indexed: 01/05/2023] Open
Abstract
In numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a meta-analysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrence-free survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
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Affiliation(s)
| | | | - Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Ibrahim Alsanie
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom; Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Ana Carolina Prado-Ribeiro
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology A C Camargo Cancer Center, São Paulo, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Adriana Franco Paes Leme
- Brazilian Bioscience National Laboratory, Brazil Center of Research in Energy and Materials, Campinas, Brazil
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3
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DeSantis KA, Robilotto SL, Matson M, Kotb NM, Lapierre CM, Minhas Z, Leder AA, Abdul K, Facteau EM, Welsh J. VDR in salivary gland homeostasis and cancer. J Steroid Biochem Mol Biol 2020; 199:105600. [PMID: 31958633 PMCID: PMC7166159 DOI: 10.1016/j.jsbmb.2020.105600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 02/06/2023]
Abstract
The vitamin D receptor (VDR) and its ligand 1,25(OH)2D3 (1,25D) impact differentiation and exert anti-tumor effects in many tissues, but its role in salivary gland has yet to be defined. Using immunohistochemistry (IHC), we have detected strong VDR expression in murine and human salivary gland ducts. Compared to normal gland, VDR protein expression was retained in differentiated human pleomorphic adenoma (PA) but was undetectable in undifferentiated PA and in carcinomas, suggesting deregulation of VDR during salivary cancer progression. To gain insight into the potential role of VDR in salivary cancer, we assessed the effects of vitamin D in vivo and in vitro. Despite the presence of VDR in salivary gland, chronic dietary vitamin D restriction did not alter morphology of the salivary epithelium in C57/Bl6 mice. The localization of VDR in ductal epithelium prompted us to examine the effects of 1,25D in an established cell line (mSGc) derived from normal murine submandibular gland (SMG). This previously characterized cell line consists of multiple stem, progenitor and differentiated cell types as determined by mutually exclusive cellular expression of basal, ductal and myoepithelial markers. We demonstrated VDR expression and regulation of VDR target genes Vdr and Postn by 1,25D in mSGc, indicating functional ligand-mediated transcriptional activity. The effect of VDR signaling on epithelial differentiation markers was assessed by qPCR and IHC in mSGc cells treated with 1,25D. We found that 1,25D reduced mRNA expression of the basal cell progenitor marker keratin 5 (K5) and increased expression of the differentiated ductal cell marker keratin 7 (K7). Further, we found that 1,25D significantly decreased the number of proliferating cells, including proliferating K5+ cells. Characterization of cell cycle by Muse cytometry indicated 1,25D treatment decreased cells in S, G2, and M phase. The inhibition of K5+ cell proliferation by 1,25D is of particular interest because K5+ basal cells contribute to a wide variety of salivary tumor types. Our studies suggest that 1,25D alters cancer-relevant progenitor and differentiation markers in the salivary gland.
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Affiliation(s)
- Kara A DeSantis
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Samantha L Robilotto
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Mark Matson
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Noor M Kotb
- Graduate Program in Biomedical Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Cathryn M Lapierre
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Undergraduate Research Program, Department of Biological Sciences, University at Albany, State University of New York, Albany, NY 12222, USA
| | - Zenab Minhas
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Undergraduate Research Program, Department of Biological Sciences, University at Albany, State University of New York, Albany, NY 12222, USA
| | - Alana A Leder
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Undergraduate Research Program, Department of Biological Sciences, University at Albany, State University of New York, Albany, NY 12222, USA
| | - Khushbakht Abdul
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Undergraduate Research Program, Department of Biological Sciences, University at Albany, State University of New York, Albany, NY 12222, USA
| | - Emily M Facteau
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Undergraduate Research Program, Department of Biological Sciences, University at Albany, State University of New York, Albany, NY 12222, USA
| | - JoEllen Welsh
- Cancer Research Center, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA.
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4
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Palicelli A. Intraductal carcinomas of the salivary glands: systematic review and classification of 93 published cases. APMIS 2020; 128:191-200. [PMID: 31697865 DOI: 10.1111/apm.13009] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 11/05/2019] [Indexed: 12/16/2022]
Abstract
Intraductal carcinomas (IDCs) are rare, not well-characterized salivary gland tumors. A systematic literature review of pure IDCs (without stromal invasion) of low-grade (LG-IDCs) or high-grade (HG-IDCs) was performed: IDCs were classified using the apocrine (AR+/S100-) vs intercalated (S100+/AR-) classification. Eighty-two LG-IDCs and 11 HG-IDCs were identified (84% parotid; 11% oral; 3% submandibular; 1% lacrimal; and 1% unknown). Out of 11 HG-IDCs, 2 HG-IDCs (18%) recurred as HG-IDC or invasive carcinoma. IDCs were classified as follows: intercalated (30%); mixed apocrine and intercalated (27%); apocrine (11%); oncocytic (6%); intercalated with focal oncocytic features (1%); and unclassifiable (25%). Double AR/S100 expressors (4%) or discrepancies between morphology and immunophenotype (9%) were found. Apocrine features and necrosis were more frequent in HG-IDCs (55%; 45%). Pleomorphism favored HG-IDCs (especially when combined with >10 mitoses/10 HPFs and/or Ki67 index >10%), being associated with apocrine areas at least in 3 HG-IDCs (27%). IDCs were typically mammaglobin+/ER-/PR-/DOG1-. No immunomarker clearly distinguished HG-IDCs from LG-IDCs. About 57% IDCs (16 LG-IDCs, 1 HG-IDC) showed RET rearrangements, including NCOA4-RET (eight intercalated and two unclassifiable IDCs) and TRIM27-RET fusions (two mixed IDCs). No ETV6, ALK-1, ROS, NTRK3, MAML2, MAML3, or PLAG1 rearrangements were identified. Complete excision and total sampling should exclude invasive areas.
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Affiliation(s)
- Andrea Palicelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
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5
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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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6
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North L, Stadler M, Massey B, Campbell B, Shukla M, Awan M, Schultz CJ, Shreenivas A, Wong S, Graboyes E, Pipkorn P, Zenga J. Intermediate-grade carcinoma of the parotid and the impact of adjuvant radiation. Am J Otolaryngol 2019; 40:102282. [PMID: 31519432 DOI: 10.1016/j.amjoto.2019.102282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To determine the influence of adjuvant radiotherapy on survival in surgically-managed early stage intermediate-grade mucoepidermoid and acinic cell carcinoma of the parotid. MATERIALS AND METHODS The National Cancer Database was reviewed between 2004 and 2015 to identify patients with intermediate-grade, early T-stage, node-negative parotid carcinoma who underwent parotidectomy ± radiotherapy. RESULTS There were 744 patients identified of which 81% had mucoepidermoid carcinoma and 19% had acinic cell carcinoma. Positive surgical margins were identified in 21% and adjuvant radiotherapy was administered in 38% of cases. Of the 159 patients with positive margins, 113 (71%) received adjuvant radiotherapy. Of the 585 patients with negative margins, 173 (30%) underwent adjuvant radiotherapy. In multivariable analysis, age (over 52 years: HR 5.19, 95%CI 2.33-11.57), insurance status (private insurance: HR 0.24 95%CI 0.13-0.43), and extent of parotidectomy (total parotidectomy: HR 2.02 95%CI 1.23-3.31) were significantly associated with overall survival, while adjuvant radiotherapy was not a significant predictive factor (HR 0.81, 95%CI 0.49-1.36). In patients with positive margin resections, however, adjuvant radiation was an independent predictor of improved survival when adjusted for age, insurance status, and extent of parotidectomy (HR 0.34, 95%CI 0.13-0.88). Conversely, in patients with negative margin resections, adjuvant radiation did not influence survival outcomes when adjusted for these covariates (HR 1.02, 95%CI 0.53-1.93). CONCLUSIONS AND RELEVANCE In patients with early stage intermediate-grade parotid carcinoma, adjuvant radiotherapy significantly and independently improves survival in those with post-operative positive margins. Adjuvant therapy, however, does not appear to improve survival outcomes in those with negative margin resections.
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Affiliation(s)
- Lauren North
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Michael Stadler
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Becky Massey
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Bruce Campbell
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Monica Shukla
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Musaddiq Awan
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Christopher J Schultz
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Aditya Shreenivas
- Department of Medical Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Stuart Wong
- Department of Medical Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Evan Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America
| | - Patrick Pipkorn
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, United States of America
| | - Joseph Zenga
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States of America.
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7
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Abdel Razek AK, Elkhamary S, Nada N. Correlation of apparent diffusion coefficient with histopathological parameters of salivary gland cancer. Int J Oral Maxillofac Surg 2019; 48:995-1000. [DOI: 10.1016/j.ijom.2019.03.897] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022]
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8
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Seethala RR, Altemani A, Ferris RL, Fonseca I, Gnepp DR, Ha P, Nagao T, Skalova A, Stenman G, Thompson LDR. Data Set for the Reporting of Carcinomas of the Major Salivary Glands: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2019; 143:578-586. [PMID: 30500293 DOI: 10.5858/arpa.2018-0422-sa] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The International Collaboration on Cancer Reporting is a nonprofit organization whose goal is to develop evidence-based, internationally agreed-upon standardized data sets for each anatomic site, to be used throughout the world. Providing global standardization of pathology tumor classification, staging, and other reporting elements will lead to achieving the objective of improved patient management and enhanced epidemiologic research. Salivary gland carcinomas are relatively uncommon, and as such, meaningful data about the many histologic types are not easily compared. Morphologic overlap between tumor types makes accurate classification challenging, but there are often significant differences in patient outcomes. Therefore, issues related to tumor type, tumor grading, high-grade transformation, extent of invasion, number and size of nerves affected, and types of ancillary studies are discussed in the context of daily application to specimens from these organs. This review focuses on the data set developed for salivary gland carcinomas with discussion of the key core and noncore elements developed for inclusion by an international expert panel of head and neck and oral-maxillofacial pathologists and surgeons.
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Affiliation(s)
- Raja R Seethala
- From the Department of Pathology and Laboratory Medicine (Dr Seethala) and Division of Head and Neck Surgery, Department of Otolaryngology (Dr Ferris), University of Pittsburgh, Pittsburgh, Pennsylvania; the Department of Anatomic Pathology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil (Dr Altemani); the Pathological Anatomy Institute, Faculdade de Medicina, Universidade de Lisboa & Serviço de Anatomia Patológica, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal (Dr Fonseca); Head and Neck Pathology, Rye Brook, New York (Dr Gnepp); the Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco (Dr Ha); the Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan (Dr Nagao); the Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic (Dr Skalova); the Department of Pathology and Genetics, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden (Dr Stenman); and the Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills (Dr Thompson)
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9
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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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10
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Cheraghlou S, Yu PK, Otremba MD, Mehra S, Yarbrough WG, Judson BL. Extracapsular extension is not a significant prognostic indicator in non-squamous cancers of the major salivary glands. CANCERS OF THE HEAD & NECK 2018; 3:5. [PMID: 31093358 PMCID: PMC6460801 DOI: 10.1186/s41199-018-0032-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/29/2018] [Indexed: 01/03/2023]
Abstract
Background Extracapsular extension (ECE) is a well-established prognostic feature in squamous cell cancers of the head and neck. Although some extrapolate data from mucosal head and neck cancer to include ECE as a high-risk feature in salivary gland cancers, data is lacking about ECE’s prognostic value for these malignancies. We investigate whether ECE is a significant prognostic indicator in pathologic node-positive cancers of the major salivary glands. Methods A retrospective study of adult salivary gland cancer cases diagnosed from 2004 to 2013 in the NCDB was conducted. Demographic, tumor, treatment, and survival variables were included in the study. Univariate Kaplan-Meier analyses, as well as multivariate Cox survival regressions were performed. Results Positive ECE status was associated with significantly worse survival in salivary SCC (HR 1.687; p = 0.002) but not non-squamous salivary cancers (HR 1.000; p = 0.998) on multivariate analysis. While post-operative radiotherapy was not associated with improved survival for patients without high-risk adverse features (high grade or positive surgical margins), its use was associated with better survival for ECE-positive salivary SCC patients without one of these additional adverse features (HR 0.064; p = 0.010). Conclusions Although ECE is a significant prognostic indicator in salivary SCC, its prognostic significance for non-squamous salivary cancers may be limited. Radiotherapy may improve survival in cases with at least one high-risk adverse feature: high grade; positive surgical margins; and for salivary SCC specifically, positive ECE status.
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Affiliation(s)
- Shayan Cheraghlou
- 1Division of Otolaryngology, Department of Surgery, Yale School of Medicine, 800 Howard Ave., YPB 425, New Haven, CT 06519 USA
| | - Phoebe K Yu
- 1Division of Otolaryngology, Department of Surgery, Yale School of Medicine, 800 Howard Ave., YPB 425, New Haven, CT 06519 USA
| | - Michael D Otremba
- 1Division of Otolaryngology, Department of Surgery, Yale School of Medicine, 800 Howard Ave., YPB 425, New Haven, CT 06519 USA.,2Yale Cancer Center, New Haven, CT USA
| | - Saral Mehra
- 1Division of Otolaryngology, Department of Surgery, Yale School of Medicine, 800 Howard Ave., YPB 425, New Haven, CT 06519 USA.,2Yale Cancer Center, New Haven, CT USA
| | - Wendell G Yarbrough
- 1Division of Otolaryngology, Department of Surgery, Yale School of Medicine, 800 Howard Ave., YPB 425, New Haven, CT 06519 USA.,2Yale Cancer Center, New Haven, CT USA.,3Department of Pathology, Yale School of Medicine, New Haven, CT USA
| | - Benjamin L Judson
- 1Division of Otolaryngology, Department of Surgery, Yale School of Medicine, 800 Howard Ave., YPB 425, New Haven, CT 06519 USA.,2Yale Cancer Center, New Haven, CT USA
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Jang JY, Choi N, Ko YH, Chung MK, Son YI, Baek CH, Baek KH, Jeong HS. Treatment outcomes in metastatic and localized high-grade salivary gland cancer: high chance of cure with surgery and post-operative radiation in T1-2 N0 high-grade salivary gland cancer. BMC Cancer 2018; 18:672. [PMID: 29925355 PMCID: PMC6011413 DOI: 10.1186/s12885-018-4578-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/07/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND High-grade salivary gland cancer is a distinct clinical entity that has aggressive disease progression and early systemic spread. However, because of the rarity of the disease, the clinical outcomes, prognostic factors and clinical decision on the optimal treatments have not been fully understood. METHODS In this study, we retrospectively analyzed the clinical data of 124 patients with high-grade salivary gland cancers and performed multivariate survival analyses to evaluate the clinico-pathological factors affecting the treatment outcomes. RESULTS The 5-year disease-specific survival was 63.4% in patients with high-grade salivary gland cancers. Among the clinico-pathological factors, presence of lymph node metastasis (hazard ratio 5.63, 95% confidence interval 2.64-12.03, P < 0.001) and distant metastasis (hazard ratio 4.59, 95% confidence interval 2.10-10.04, P < 0.001) at diagnosis were the most potent unfavorable prognostic factors. Importantly, patients with early-stage disease (T1-2N0M0) showed apparently a relatively excellent prognosis (93.2% 5-year disease-specific survival); meanwhile N (+) and M1 status at diagnosis resulted in dismal outcomes (44.6 and 21.1% 5-year disease-specific survival, respectively). On comparing surgery alone as a treatment modality, surgery plus postoperative radiation significantly benefited the patients, but the difference between adjuvant radiation and chemoradiation was not found to be significant. Pathological subtypes of high-grade salivary gland cancers were not significantly associated with prognosis. CONCLUSIONS Despite of an overall unfavorable prognosis in high-grade salivary gland cancer, patients with early-stage disease are expected to have excellent prognosis (over 90% survival rates) with surgery plus adjuvant radiation, which may implicate the patients' consultation, therapeutic decision making, and the need for early detection of the disease.
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Affiliation(s)
- Jeon Yeob Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Nayeon Choi
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Kwan-Hyuck Baek
- Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
| | - Han-Sin Jeong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Qian K, Di L, Guo K, Zheng X, Ji Q, Wang Z. Cervical Lymph Node Metastatic Status and Adjuvant Therapy Predict the Prognosis of Salivary Duct Carcinoma. J Oral Maxillofac Surg 2018; 76:1578-1586. [PMID: 29544756 DOI: 10.1016/j.joms.2018.01.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/08/2018] [Accepted: 01/29/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Salivary duct carcinoma (SDC) is an aggressive malignancy that is not yet fully understood. We designed the present retrospective study to investigate the factors affecting the prognosis of SDC and the effects of adjuvant therapies on the clinical outcomes of patients. MATERIALS AND METHODS Patients with SDC treated surgically from 2006 to 2016 were enrolled in the present retrospective cohort study. The demographic data, clinical pathologic characteristics, and follow-up results were recorded. The prognostic indicators of overall survival (OS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS) were analyzed using the Kaplan-Meier method and the Cox proportional hazard model. RESULTS The study sample included 66 patients, most of whom were male (81.8%). The 5-year OS, LRFFS, and DMFS for all patients was 52.5%, 63.9%, and 51.3%, respectively. Univariate analysis showed that stage N2-N3, lymph node involvement of levels IV and V, 8 or more positive lymph nodes, and extranodal extension were all negative prognostic indicators for OS. The only significant indicator on multivariate analysis was the number of positive lymph nodes. Multivariate analysis revealed that extracapsular invasion and no adjuvant radiotherapy were risk factors for LRFFS. In contrast, lesions involving both glands and 8 or more positive lymph nodes were prognostic factors for DMFS. Further subgroup analysis showed that radiotherapy was only useful for patients with locally advanced lesions for local control. CONCLUSIONS Cervical lymph node metastatic status is an important factor in predicting the prognosis of SDC patients. Adjuvant radiotherapy is useful for local control, especially for patients with stage T4 disease but does not benefit OS and DMFS.
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Affiliation(s)
- Kai Qian
- Resident, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lu Di
- Resident, Departments of Oncology and Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kai Guo
- Resident, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoke Zheng
- Resident, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qinghai Ji
- Professor, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuoying Wang
- Professor, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
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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: 69] [Impact Index Per Article: 9.9] [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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