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Yan F, Liu JC, Shulman R, Galloway TJ, Ridge JA, Yao CMKL. Timing of postoperative radiation therapy for major salivary gland cancers. Head Neck 2024. [PMID: 38864240 DOI: 10.1002/hed.27845] [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: 02/17/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The impact of timing of PORT initiation for major salivary gland cancers on survival is unknown. We aim to examine the impact of PORT timeliness on overall survival (OS) of patients with major salivary gland cancers. METHODS This was a cross-sectional analysis using data from the National Cancer Database (2004-2017) and included patients with major salivary gland cancer treated with surgery and PORT. RESULTS In total, 5701 patients were included (3133 [55%] male, 4644 [82%] white, mean age 59 ± 16 years). For the overall cohort, PORT >6 weeks was not associated with decreased OS (1.00 aHR, 95% CI 0.89-1.11). When specifically examining patients with mucoepidermoid carcinoma, PORT >6 weeks was associated with a decreased OS (1.27 aHR, 95% CI 1.01-1.58). CONCLUSIONS Overall, this analysis did not demonstrate a survival benefit for initiating PORT within 6 weeks for patients with salivary gland malignancies. Subset analysis did support initiating PORT within 6 weeks after resection for patients with mucoepidermoid carcinomas. This was not demonstrated in other major salivary gland cancer histologies.
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Affiliation(s)
- Flora Yan
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Jeffrey C Liu
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
- Division of Head and Neck Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Rebecca Shulman
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Thomas J Galloway
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - John A Ridge
- Division of Head and Neck Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Christopher M K L Yao
- Department of Otolaryngology - Head & Neck Surgery, University Health Network, Toronto, Ontario, Canada
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2
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Aral İP, İnan GA, Gökçe E, Gani Z, Ergün D, Arslan N, Akinci MB, Tezcan Y. Evaluation of the efficacy of adjuvant radiotherapy versus chemoradiotherapy in patients with salivary gland tumors. J Cancer Res Ther 2024; 20:850-857. [PMID: 38261449 DOI: 10.4103/jcrt.jcrt_2739_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 01/25/2024]
Abstract
AIMS The aim of this study was to compare the efficacy of adjuvant radiotherapy (RT) versus adjuvant chemoradiotherapy (CRT) in patients with salivary gland tumors (SGTs). MATERIALS AND METHODS Data from patients who underwent adjuvant RT for a diagnosis of SG cancer at Ankara Atatürk Education and Research Hospital, Ankara Numune Education and Research Hospital and Ankara Bilkent City Hospital between September 01, 2009 and September 01, 2022 were analysed retrospectively. We evaluated the efficacy of RT alone versus CRT in these patients in terms of acute response, treatment tolerance, overall survival (OS), and disease-free survival (DFS). RESULTS Fifty-five patients who underwent RT between September 14, 2009 and August 04, 2022 at Ankara Atatürk Education and Research Hospital, Ankara Numune Education and Research Hospital and Ankara Bilkent City Hospital were included in this study. Eight patients who did not meet the study criteria were excluded; thus, the analysis was performed for 47 patients. The median follow-up period was 60 months (range: 6-160 months). The median patient age was 53 years (range: 18-86 years). Thirty-nine patients (83%) had parotid tumors and eight patients (17%) had submandibular cancer. The time from surgery to RT was 48 days (range: 20-126 days). Intensity-modulated radiotherapy was administered to all patients and the median RT dose was 66 Gy (range: 52-70 Gy). Concomitant chemotherapy (CCT) (40 mg/m 2 of cisplatin weekly) was administered to 13 patients (27.7%). Acute adverse events were observed in 17 patients (36.2%). Interruption of RT was noted for only six patients (12.8%), and this proportion did not differ significantly between the CRT and RT-only arms ( P = 0.538). Acute side effects were observed in 17 patients (36.2%), and there were no significant relationships between acute side effects and the administration of CCT ( P = 0.112). Recurrence was observed in 10 patients (21.3%). All recurrences were locoregional and no distant metastases were observed during the follow-up period. The median DFS of the patients was 48 months (range: 4-160 months), 1-year DFS was 86%, 2-year DFS was 83.5%, and 5-year DFS was 77.9%. There was no statistically significant difference in DFS between the adjuvant CRT and RT-alone arms ( P = 0.114). At the date of last follow-up, 14 patients (29.8%) had died. The median OS of the patients was 58.5 months (range: 6-160 months), 1-year OS was 91.4%, 2-year OS was 86.8%, and 5-year OS was 78%. There was no statistically significant difference in OS between the adjuvant CRT and RT-only arms ( P = 0.453). CONCLUSION Stage was identified as the most important prognostic factor for DFS and OS. No significant differences in OS, DFS, or acute side effects were observed between the CRT and RT-only arms. Additional studies are needed to identify the subgroup of SGT patients for which CRT is most warranted.
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Affiliation(s)
- İpek P Aral
- Radiation Oncology Clinic, Ankara Yıldırım Beyazıt University, Ankara, Turkey
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Gonca A İnan
- Radiation Oncology Clinic, Ankara Yıldırım Beyazıt University, Ankara, Turkey
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Ezgi Gökçe
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Zerrin Gani
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Dilem Ergün
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Nalan Arslan
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
| | | | - Yılmaz Tezcan
- Radiation Oncology Clinic, Ankara Yıldırım Beyazıt University, Ankara, Turkey
- Radiation Oncology Clinic, Ankara City Hospital, Ankara, Turkey
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3
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Thariat J, Ferrand FR, Fakhry N, Even C, Vergez S, Chabrillac E, Sarradin V, Digue L, Troussier I, Bensadoun RJ. Radiotherapy for salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00158-8. [PMID: 38030445 DOI: 10.1016/j.anorl.2023.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To determine the indications for radiotherapy in salivary gland cancer and to specify the modalities and target radiation volumes. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS Postoperatively, radiotherapy to the primary tumor site±to the lymph nodes is indicated if one or more of the following adverse histoprognostic factors are present (risk>10% of locoregional recurrence): T3-T4 category, lymph node invasion, extraglandular invasion, close or positive surgical margins, high tumor grade, perineural invasion, vascular emboli, and/or bone invasion. Intensity-modulated radiation therapy (IMRT) is the gold standard. For unresectable cancers or inoperable patients, carbon ion hadrontherapy may be considered. CONCLUSION Radiotherapy in salivary gland cancer is indicated in postoperative situations in case of adverse histoprognostic factors and for inoperable tumors.
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Affiliation(s)
- J Thariat
- Département de radiothérapie, centre François-Baclesse, Caen, France
| | - F-R Ferrand
- French Armed Forces Biomedical Research Institute, 91220 Brétigny-sur-Orge, France; Département d'oncologie médicale, institut Gustave-Roussy, Villejuif, France
| | - N Fakhry
- Département d'ORL et chirurgie cervico-faciale, hôpital La Conception, AP-HM, Aix-Marseille University, 147, boulevard Baille, 13005 Marseille, France.
| | - C Even
- Département d'oncologie médicale, institut Gustave-Roussy, Villejuif, France
| | - S Vergez
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France; Département de chirurgie ORL et cervico-faciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, Toulouse, France
| | - E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France
| | - V Sarradin
- Département d'oncologie médicale, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France
| | - L Digue
- Département d'oncologie médicale, hôpital Saint-André, Bordeaux, France
| | - I Troussier
- Département d'oncologie radiothérapie, centre de haute énergie, Nice, France
| | - R-J Bensadoun
- Département d'oncologie radiothérapie, centre de haute énergie, Nice, France
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4
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Chabrillac E, Vergez S, Barry B, Jegoux F, Verillaud B, Pham Dang N, Baujat B, Fakhry N. Post-treatment monitoring of salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00155-2. [PMID: 38030444 DOI: 10.1016/j.anorl.2023.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To determine the frequency and modality of post-treatment monitoring of primary salivary gland cancer. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS Clinical monitoring should be adapted to the risk of recurrence: initially every 3 months and progressively spaced out, becoming annual after 5 years. Post-treatment head and neck and chest imaging is recommended at 3 months. Local and regional monitoring can then be carried out yearly or twice yearly with contrast-enhanced head and neck imaging. An annual chest CT scan is recommended for high-grade tumors. For lesions at high risk of late recurrence, very prolonged annual surveillance (up to 15 years) is recommended, including screening for pulmonary metastases. CONCLUSION Given the wide range of malignant salivary gland tumors, the modalities and frequency of post-treatment monitoring must be adapted to the expected course of the disease.
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Affiliation(s)
- E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - S Vergez
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France; Département de chirurgie ORL et cervico-faciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, Toulouse, France
| | - B Barry
- Département d'ORL et chirurgie cervico-faciale, hôpital Bichat, AP-HP, Paris, France
| | - F Jegoux
- Département d'ORL et chirurgie cervico-faciale, CHU de Rennes, Rennes, France
| | - B Verillaud
- Département d'ORL et de chirurgie cervico-faciale, hôpital Lariboisière, AP-HP, Inserm U1141, université Paris Cité, Paris, France
| | - N Pham Dang
- Service de chirurgie maxillo-faciale, université Clermont-Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - B Baujat
- Département d'ORL et chirurgie cervico-faciale, Sorbonne université, hôpital Tenon, AP-HP, Paris, France
| | - N Fakhry
- Département d'ORL et chirurgie cervico-faciale, hôpital La Conception, AP-HM, Marseille, France
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5
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Benchetrit L, Mehra S, Mahajan A, Rahmati RW, Judson BL, Edwards HA. Major Salivary Gland Cancer With Distant Metastasis Upon Presentation: Patterns, Outcomes, and Imaging Implications. Otolaryngol Head Neck Surg 2022; 167:305-315. [PMID: 34784258 DOI: 10.1177/01945998211058354] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Given limited data availability on distant metastasis (DM) in major salivary gland (MSG) malignancy presentation, we aimed to evaluate the rate, histologic patterns, location, and predictors of DM at first MSG cancer presentation and suggest potential implications on diagnostic workup. STUDY DESIGN Retrospective cohort. SETTING Commission on Cancer-accredited hospitals. METHODS We included patients in the National Cancer Database (2010-2016) with MSG malignancy. Site and rate of DM were stratified by histologic subtype. Factors predictive of DM at presentation were determined by multivariate regression analysis. Survival analyses were conducted via the Kaplan-Meier method, log-rank test, and Cox regression analysis. RESULTS Of 5776 patients with MSG carcinoma, 333 (5.8%) presented with DM. The most common DM site was the lung (57.1%), followed by bone (46.8%) and liver (19.5%). DM was most common in adenocarcinoma-not otherwise specified (15.1%, 132/874) and salivary duct carcinoma (10.4%, 30/288). High-grade mucoepidermoid carcinoma had the highest rate of lung metastases (81.6%, 31/38). Conversely, myoepithelial carcinoma had the highest rate of bone metastases (85.7%, 6/7). DM at presentation was independently associated with an increased mortality risk (hazard ratio, 1.62; 95% CI, 1.40-1.90). CONCLUSION We identified a DM rate of 5.8% in MSG malignancy at presentation. Overall 43% of patients presented without DM to the lung but with DM to the bones, liver, and/or brain. The most common metastatic sites differed by tumor histology. Staging with computed tomography neck and chest alone may fail to detect sites of DM; this work can be used for patient counseling in the clinical setting.
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Affiliation(s)
- Liliya Benchetrit
- Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, Massachusetts, USA
| | - Saral Mehra
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
| | - Amit Mahajan
- Department of Radiology and Biomedical Imaging, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Rahmatullah W Rahmati
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
| | - Benjamin L Judson
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
| | - Heather A Edwards
- Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, Massachusetts, USA.,School of Medicine, Boston University, Boston, Massachusetts, USA
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6
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Zang S, Chen M, Huang H, Zhu X, Li X, Yan D, Yan S. Oncological outcomes of patients with salivary gland cancer treated with surgery and postoperative intensity-modulated radiotherapy: a retrospective cohort study. Quant Imaging Med Surg 2022; 12:2841-2854. [PMID: 35502385 PMCID: PMC9014160 DOI: 10.21037/qims-21-836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/14/2022] [Indexed: 04/16/2024]
Abstract
BACKGROUND Salivary gland cancer (SGC) is relatively rare and constitutes a variety of histological subtypes. Previously published studies of SGC patients suggest that postoperative radiation using conventional radiotherapy (RT) or 3-dimensional (3D) conformal radiotherapy may have led to suboptimal oncological outcomes. METHODS We identified 60 patients with major SGC treated with surgery followed by postoperative intensity-modulated radiotherapy (IMRT). Data for overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), prognostic factors, and treatment-related toxicities were analyzed. Survival was analyzed using the Kaplan-Meier method and compared using the log-rank test. RESULTS With a median follow-up of 55.5 months, based on Kaplan-Meier analyses, the OS and PFS rates for SGC patients at 3, 5, and 10 years were 90.7%, 85.1%, and 85.1% and 80.1%, 72.7%, and 63.1%, respectively. The LRRFS and DMFS rates at 3, 5, and 10 years were 87.4%, 82.1%, and 82.1% and 85.3%, 78.4%, and 66.1%, respectively. In multivariable analysis (MVA), the node stage (N stage) was an independent predictor of PFS [P=0.047; hazard ratio (HR) =0.089]. A positive margin was a significant prognostic factor for PFS (P=0.036; HR =4.086), LRRFS (P=0.026; HR =5.064), and DMFS (P=0.011; HR =6.367). Major nerve involvement was significantly correlated with PFS (P=0.034; HR =2.394) and DMFS (P=0.008; HR =2.115). The interval from surgery to radiotherapy predicted PFS (P=0.036; HR =3.934) and DMFS (P=0.012; HR =6.231). Adenoid cystic carcinoma (ACC) was the most common histology (n=21; 35%). For ACC, the 5-year OS, PFS, LRRFS, and DMFS were 100%, 67.7%, 76.2%, and 90.2%, respectively. The most common acute toxicities were mucositis and dermatitis, and xerostomia was the most common late adverse event. Lung metastasis was the most common pattern of distant failure. CONCLUSIONS N stage, positive margin, major nerve involvement, and interval from surgery to radiotherapy were important factors associated with PFS, LRRFS, and DMFS. Postoperative IMRT leads to improved survival for SGC patients, with acceptable toxicities.
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Affiliation(s)
- Shoumei Zang
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Meiqin Chen
- Department of Radiation Oncology, Affiliated Jinhua Hospital, College of Medicine, Zhejiang University, Jinhua, China
| | - Huijie Huang
- Department of Radiation Oncology, Yili Friendship Hospital, Yili, China
| | - Xinli Zhu
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xinke Li
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Danfang Yan
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Senxiang Yan
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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7
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Thierauf JC, Farahani AA, Indave BI, Bard AZ, White VA, Smith CR, Marble H, Hyrcza MD, Chan JKC, Bishop J, Shi Q, Ely K, Agaimy A, Martinez-Lage M, Nose V, Rivera M, Nardi V, Dias-Santagata D, Garg S, Sadow P, Le LP, Faquin W, Ritterhouse LL, Cree IA, Iafrate AJ, Lennerz JK. Diagnostic Value of MAML2 Rearrangements in Mucoepidermoid Carcinoma. Int J Mol Sci 2022; 23:4322. [PMID: 35457138 PMCID: PMC9026998 DOI: 10.3390/ijms23084322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is often seen in salivary glands and can harbor MAML2 translocations (MAML2+). The translocation status has diagnostic utility as an objective confirmation of the MEC diagnosis, for example, when distinction from the more aggressive adenosquamous carcinoma (ASC) is not straightforward. To assess the diagnostic relevance of MAML2, we examined our 5-year experience in prospective testing of 8106 solid tumors using RNA-seq panel testing in combinations with a two-round Delphi-based scenario survey. The prevalence of MAML2+ across all tumors was 0.28% (n = 23/8106) and the majority of MAML2+ cases were found in head and neck tumors (78.3%), where the overall prevalence was 5.9% (n = 18/307). The sensitivity of MAML2 for MEC was 60% and most cases (80%) were submitted for diagnostic confirmation; in 24% of cases, the MAML2 results changed the working diagnosis. An independent survey of 15 experts showed relative importance indexes of 0.8 and 0.65 for "confirmatory MAML2 testing" in suspected MEC and ASC, respectively. Real-world evidence confirmed that the added value of MAML2 is a composite of an imperfect confirmation test for MEC and a highly specific exclusion tool for the diagnosis of ASC. Real-world evidence can help move a rare molecular-genetic biomarker from an emerging tool to the clinic.
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Affiliation(s)
- Julia C. Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital and Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Alex A. Farahani
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - B. Iciar Indave
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Adam Z. Bard
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Valerie A. White
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Cameron R. Smith
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Hetal Marble
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB 2500, Canada;
| | - John K. C. Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China;
| | - Justin Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Qiuying Shi
- Department of Pathology, Emory University Hospital, Atlanta, GA 30322, USA;
| | - Kim Ely
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Abbas Agaimy
- Institute of Pathology, Friedrich Alexander University Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany;
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Vania Nose
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Miguel Rivera
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Valentina Nardi
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Dora Dias-Santagata
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Salil Garg
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Peter Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Long P. Le
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Lauren L. Ritterhouse
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Ian A. Cree
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - A. John Iafrate
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Jochen K. Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
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8
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Pang J, Houlton JJ. Management of Malignant Salivary Gland Conditions. Surg Clin North Am 2022; 102:325-333. [PMID: 35344700 DOI: 10.1016/j.suc.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Salivary cancers are rare tumors that arise in major and minor salivary glands. Workup almost always includes fine-needle aspiration or core needle biopsy in select cases. Imaging with ultrasound, computed tomography, or MRI is also helpful, particularly with MRI to assess facial nerve involvement or skull base involvement. Preserving function of the facial nerve is of paramount importance, and the standard of care is to not sacrifice facial nerve except in instances of gross encasement and inability to dissect tumor off of the nerve. Adjuvant radiation and chemotherapy offer survival advantages for select patients.
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Affiliation(s)
- John Pang
- University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
| | - Jeffrey J Houlton
- Otolaryngology-Head and Neck Surgery, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA.
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9
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Yang Y, Wang S, Ma P, Tang Q, Li Y, Fang Y, Zhu Q, Tao W, Zha Y, Li N. CEA-Regulated Oncolytic Virus Anticancer Therapy: A Promising Strategy for Rare Solid Tumors. Curr Cancer Drug Targets 2022; 22:126-132. [PMID: 35114923 DOI: 10.2174/1568009622666220202143852] [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: 11/08/2021] [Revised: 11/19/2021] [Accepted: 12/08/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rare solid tumors have attracted much more attention due to the great unmet clinical need, limited treatment options, and poor prognosis. As the most thoroughly studied tumor marker, carcinoembryonic antigen (CEA) can not only overexpress in various common solid tumors, but also in several rare solid tumors. Oncolytic virus therapy has achieved excellent anticancer effects in the past decades. Due to the specific high expression of CEA in certain tumor tissues, but not in normal tissues, CEA has been applied to improve the tumor specificity of gene expression. METHODS The studies of CEA expression in rare solid tumors and CEA-regulated oncolytic virus therapy were reviewed. RESULTS We showed the types of rare solid tumors with overexpression of CEA. Elevated serum CEA levels can indicate the diagnosis, response of surgery or system therapy, distal metastasis, recurrence, and survival. Due to high tumor specificity, CEA-regulated OA therapy has demonstrated a surprising antitumor effect for common CEA-positive tumors in preclinical trials Conclusion: These data suggested that CEA could be a diagnostic and prognostic biomarker for several rare solid tumors. We proposed the hypothesis that CEA-regulated oncolytic virus therapy could be a promising therapeutic strategy for CEA-positive rare solid tumors.
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Affiliation(s)
- Yuqi Yang
- NHC Key Laboratory of Pulmonary Immune-related Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Shuhang Wang
- National Cancer Center, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Peiwen Ma
- National Cancer Center, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Qiyu Tang
- National Cancer Center, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Yandong Li
- Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yuan Fang
- National Cancer Center, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Qi Zhu
- Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Wuhan, Chinav
| | - Wei Tao
- asic Medicine and Clinical Pharmacy, China Pharmaceutical University, Wuhan, China
| | - Yan Zha
- NHC Key Laboratory of Pulmonary Immune-related Disease, Guizhou Provincial People's Hospital, Guiyang, China; bNational
| | - Ning Li
- National Cancer Center, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
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10
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Mueller SK, Haderlein M, Lettmaier S, Agaimy A, Haller F, Hecht M, Fietkau R, Iro H, Mantsopoulos K. Targeted Therapy, Chemotherapy, Immunotherapy and Novel Treatment Options for Different Subtypes of Salivary Gland Cancer. J Clin Med 2022; 11:jcm11030720. [PMID: 35160172 PMCID: PMC8836387 DOI: 10.3390/jcm11030720] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022] Open
Abstract
Surgical resection remains the first line treatment for salivary gland cancer (SGC). In the case of locally advanced disease, surgery is followed by adjuvant radiotherapy. Surgical resection should be favored in resectable locoregional recurrent disease as well, and even the complete resection of all distant oligometastases has clinical benefit for the patients. For inoperable and disseminated metastatic disease, a multitude of systemic therapies including chemotherapy, targeted therapy, and immunotherapy are available. In this review, the current therapeutic options for inoperable recurrent or metastatic SGCs are summarized. Systemic treatment can achieve prolonged progression-free and overall survival, while the overall prognosis remains poor. Current clinical trials include only a limited number of patients and mostly combine different histologic subtypes. Additionally, no randomized controlled trial comparing different therapeutic options has been performed. In the future, further studies with a larger patient cohort and ideally only one histologic subtype are needed in order to improve the outcome for SGC patients. However, this may be difficult to accomplish due to the rarity and diversity of the disease. Additionally, molecular analyses need to be performed routinely in order to individualize treatment and to go one step further towards precision medicine.
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Affiliation(s)
- Sarina K. Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Correspondence:
| | - Marlen Haderlein
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Sebastian Lettmaier
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Abbas Agaimy
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.A.); (F.H.)
| | - Florian Haller
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.A.); (F.H.)
| | - Markus Hecht
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Rainer Fietkau
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
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11
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Taniguchi S, Tanaka Y, Elhance A, Oshimori N. A mechanistic basis for the malignant progression of salivary gland tumors. iScience 2021; 24:103508. [PMID: 34934927 PMCID: PMC8661530 DOI: 10.1016/j.isci.2021.103508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/25/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022] Open
Abstract
Salivary gland tumors are diverse neoplasms, likely reflecting differences in the tissue- and cell-of-origin. 80%-90% of tumors arising in the sublingual gland (SLG) are malignant, whereas the other major glands often form benign tumors. Owing to the lack of experimental models to explore the etiology of salivary gland tumors, the cellular and molecular bases of malignancy remain unknown. Here, we generated a murine model of HRASG12V-driven salivary gland tumors amenable to examine tumor onset and malignant progression. We found that HMGA2 marks the tumor onset, and transformed-SOX2+ stem/progenitor cells expand exclusively in SLG tumors. Lineage tracing experiments showed that SLG tumor cells undergo an extensive epithelial-mesenchymal transition (EMT) and TGF-β-responding tumor cells are a source of mesenchymal tumor cells invading the surrounding stroma. This study advances our understanding of the mechanistic basis of salivary gland malignancy and may help combat this highly heterogeneous cancer.
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Affiliation(s)
- Sachiko Taniguchi
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Yuya Tanaka
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Ajit Elhance
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Naoki Oshimori
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Dermatology, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Otolaryngology, Head & Neck Surgery, Oregon Health and Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
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12
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Bradley PJ. Parotid lymph nodes in primary malignant salivary neoplasms. Curr Opin Otolaryngol Head Neck Surg 2021; 30:99-106. [DOI: 10.1097/moo.0000000000000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Challenges Faced by Clinicians in the Personalized Treatment Planning: A Literature Review and the First Results of the Russian National Cancer Program. Crit Care Res Pract 2021; 2021:6649771. [PMID: 34603796 PMCID: PMC8483928 DOI: 10.1155/2021/6649771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
Advances in cancer molecular profiling have enabled the development of more effective approaches to the diagnosis and personalized treatment of tumors. However, treatment planning has become more labor intensive, requiring hours or even days of clinician effort to optimize an individual patient case in a trial-and-error manner. Lessons learned from the world cancer programs provide insights into ways to develop approaches for the treatment strategy definition which can be introduced into clinical practice. This article highlights the variety of breakthroughs in patients' cancer treatment and some challenges that this field faces now in Russia. In this report, we consider the key characteristics for planning an optimal clinical treatment regimen and which should be included in the algorithm of clinical decision support systems. We discuss the perspectives of implementing artificial intelligence-based systems in cancer treatment planning in Russia.
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Roch M, Mauvais O, Vergez S, Brenet E, Lindas P, Toussaint B, Nguyen DT, Gauchotte G, Rumeau C, Gallet P. Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter Retrospective Study. Ann Otol Rhinol Laryngol 2021; 131:782-790. [PMID: 34496666 DOI: 10.1177/00034894211045269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Close margin is a frequent situation after parotidectomy. The need for systematic prophylactic revision surgery is a question that arises regularly for malignant tumors, as it exposes to a high risk of facial palsy, while oncological benefits are unclear. STUDY DESIGN retrospective study. SETTING Multicentric. SUBJECTS AND METHODS We included all patients operated for systematic revision surgery in case of close margins after parotidectomy for a malignant tumor and analyzed the rate of tumor residue and its risk factors. RESULTS A tumor residue was identified in 43.5% of 23 cases, but none in case of initial complete excision with supra-millimetric margins. Invaded lymph nodes were identified in 6 cases, but none in case of low-grade tumors. CONCLUSIONS Systematic revision seems mandatory in case of infra-millimetric margins and high-grade tumors or positive lymph node; further studies are needed to confirm whether it can be spared for T1-T2/N0 low-grade tumors, with close margins but complete initial excision.
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Affiliation(s)
- Médarine Roch
- ENT Department, Regional University Hospital of Nancy, Nancy, France
| | - Olivier Mauvais
- ENT Department, Regional University Hospital of Besancon, Besancon, France
| | - Sebastien Vergez
- ENT Department, Regional University Hospital of Toulouse, Toulouse, France
| | - Esteban Brenet
- ENT Department, Regional University Hospital of Reims, Reims, France
| | - Pierre Lindas
- ENT Department, Robert Schuman Hospital, Metz, France
| | - Bruno Toussaint
- ENT Department, Regional University Hospital of Nancy, Nancy, France
| | - Duc Trung Nguyen
- ENT Department, Regional University Hospital of Nancy, Nancy, France
| | | | - Cécile Rumeau
- ENT Department, Regional University Hospital of Nancy, Nancy, France
| | - Patrice Gallet
- ENT Department, Regional University Hospital of Nancy, Nancy, France
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15
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High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases. Eur Arch Otorhinolaryngol 2021; 279:2553-2563. [PMID: 34436631 PMCID: PMC8986716 DOI: 10.1007/s00405-021-07024-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022]
Abstract
Purpose Salivary Gland cancer (SGC) is a rare and heterogenous group of tumors. Standard therapeutic options achieve high local but poor distant control rates, especially in high-grade SGC. The aim of this monocentric study was to evaluate patterns of recurrence and its treatment options (local ablative vs. systemic) in a homogenously treated patient population with high-grade SGC after surgery and radio(chemo)therapy. Methods Monocentric, retrospective study of patients with newly diagnosed high-grade salivary gland cancer. We retrospectively reviewed clinical reports from 69 patients with high-grade salivary gland cancer in a single-center audit. Survival rates were calculated using the Kaplan–Meier method and prognostic variables were analyzed (univariate analysis: log-rank test; multivariate analysis: Cox regression analysis). Results The median time of follow-up was 31 months. After 5 years, the cumulative overall survival was 65.2%, cumulative incidence of local recurrence was 7.2%, whereas the cumulative incidence of distant metastases was 43.5% after 5 years. 30 of 69 patients developed distant metastases during the time of follow-up, especially patients with adenoid cystic carcinoma, salivary duct carcinoma, adenocarcinoma NOS and acinic cell carcinoma with high-grade transformation. The most common type of therapy therefore was chemotherapy (50%). 85.7% of patients with local ablative therapy of distant metastases show disease progression during follow-up afterwards. Conclusion With surgery and radio-chemotherapy, a high rate of loco-regional control is reached, but over 40% of patients develop distant metastases in the further follow-up which usually present a diffuse pattern involving in a diffuse metastases. Therefore, in the future, intensified interdisciplinary combination therapies even in the first-line treatment in certain subtypes of high-grade SGC should be investigated. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07024-9.
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16
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Yamamoto H, Kojima T, Okanoue Y, Otsuki S, Hasebe K, Yuki R, Hori R. Impact of Changing Surgical Strategies on Clinical Outcomes in Patients with Parotid Carcinoma: A 53-Year Single-Institution Experience. MEDICINA-LITHUANIA 2021; 57:medicina57080745. [PMID: 34440951 PMCID: PMC8399018 DOI: 10.3390/medicina57080745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/18/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: We investigated the clinical outcomes of patients who underwent surgery for parotid carcinoma in a single institution during a 53-year period. This study aimed to estimate the impact of changing the surgical approach to parotid carcinoma on clinical outcomes including the incidence rate of the facial nerve palsy. Materials and Methods: Sixty-seven patients with parotid carcinoma who underwent surgery between 1966 and 2018 were retrospectively reviewed. Group A consisted of 29 patients who underwent surgery from 1966 to 2002, and Group B consisted of 38 patients from 2002 to 2018. Treatment outcomes were estimated. Additionally, candidate prognostic factors of Group B, the current surgical approach group, were evaluated. Results: Partial parotidectomy and total parotidectomy were performed in 35 and 32 patients, respectively. Partial parotidectomy was performed in 4 patients in Group A and 31 patients in Group B, with a predominant increase in Group B. The facial nerve was preserved in 43 patients, among whom 8 in Group A (8/17; 47.1%) and 7 in Group B (7/26; 26.9%) had temporary postoperative facial nerve palsy. Postoperative radiotherapy was performed on 35 patients. The 5-year OS, DSS, and DFS rates for Group A were 77.1%, 79.9%, and 71.5%, respectively. The 5-year OS, DSS, and DFS rates for Group B were 77.1%, 77.1%, and 72.4%, respectively. Clinical T4 stage, clinical N+ stage, stage IV disease, and tumor invasion of the facial nerve were independent prognostic factors in Group B. Conclusions: The incidence of facial nerve palsy in the current surgical approach group decreased compared with that in the previous surgical approach group. The current surgical management and treatment policies for parotid carcinoma have led to improved outcomes.
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Affiliation(s)
- Hirotaka Yamamoto
- Department of Otolaryngology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan; (H.Y.); (T.K.); (Y.O.); (S.O.); (K.H.); (R.Y.)
- Department of Otolaryngology, Shizuoka City Hospital, 10-93 Otte-cho, Aoi-ku, Shizuoka 420-8630, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan; (H.Y.); (T.K.); (Y.O.); (S.O.); (K.H.); (R.Y.)
| | - Yusuke Okanoue
- Department of Otolaryngology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan; (H.Y.); (T.K.); (Y.O.); (S.O.); (K.H.); (R.Y.)
| | - Shuya Otsuki
- Department of Otolaryngology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan; (H.Y.); (T.K.); (Y.O.); (S.O.); (K.H.); (R.Y.)
| | - Koki Hasebe
- Department of Otolaryngology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan; (H.Y.); (T.K.); (Y.O.); (S.O.); (K.H.); (R.Y.)
| | - Ryohei Yuki
- Department of Otolaryngology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan; (H.Y.); (T.K.); (Y.O.); (S.O.); (K.H.); (R.Y.)
| | - Ryusuke Hori
- Department of Otolaryngology—Head and Neck Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
- Correspondence: ; Tel.: +81-562-93-9291
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17
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Geiger JL, Ismaila N, Beadle B, Caudell JJ, Chau N, Deschler D, Glastonbury C, Kaufman M, Lamarre E, Lau HY, Licitra L, Moore MG, Rodriguez C, Roshal A, Seethala R, Swiecicki P, Ha P. Management of Salivary Gland Malignancy: ASCO Guideline. J Clin Oncol 2021; 39:1909-1941. [PMID: 33900808 DOI: 10.1200/jco.21.00449] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations for practicing physicians and other healthcare providers on the management of salivary gland malignancy. METHODS ASCO convened an Expert Panel of medical oncology, surgical oncology, radiation oncology, neuroradiology, pathology, and patient advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2020. Outcomes of interest included survival, diagnostic accuracy, disease recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 293 relevant studies to inform the evidence base for this guideline. Six main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, and follow-up evaluations. RECOMMENDATIONS When possible, evidence-based recommendations were developed to address the diagnosis and appropriate preoperative evaluations for patients with a salivary gland malignancy, therapeutic procedures, and appropriate treatment options in various salivary gland histologies.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Marnie Kaufman
- Adenoid Cystic Carcinoma Research Foundation, Needham, MA
| | | | | | - Lisa Licitra
- Istituto Nazionale Tumori, Milan, Italy.,University of Milan, Milan, Italy
| | | | | | | | | | | | - Patrick Ha
- University of California San Francisco, San Francisco, CA
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Pouloudi D, Manou M, Sarantis P, Tsoukalas N, Tsourouflis G, Dana E, Karamouzis MV, Klijanienko J, Theocharis S. Clinical Significance of Histone Deacetylase (HDAC)-1, -2, -4 and -6 Expression in Salivary Gland Tumors. Diagnostics (Basel) 2021; 11:diagnostics11030517. [PMID: 33799478 PMCID: PMC8000873 DOI: 10.3390/diagnostics11030517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/13/2022] Open
Abstract
Salivary gland tumors (SGTs) comprise a group of rare neoplasms. Locally aggressive, recurrent and/or metastatic SGTs are notorious for their resistance to systemic therapy, making the need for carefully designed, prospective and randomized trials with useful predictive markers mandatory to define new effective therapeutic protocols. Histone Deacetylases (HDACs), are thought to play a crucial role in carcinogenesis. They affect the DNA structure, being also able to regulate its transcription, repair, and replication. This study aimed to evaluate-to our knowledge for the first time-the HDAC-1, -2, -4 and -6 immunohistochemical expression in SGTs and their potential use as prognostic biomarkers. Medical records and archival histopathological material of 58 (36 benign and 22 malignant) SGT patients were included in this study. The H-score was statistically correlated with the clinicopathological characteristics for all cases and patients' survival rate in malignant SGTs. HDAC-2 positivity was significantly associated with more prolonged overall survival (OS) of patients with malignant SGTs (p = 0.028), while HDAC-2 positivity and no HDAC-6 expression were associated with prolonged OS of patients with HG malignant SGT (p = 0.003 and p = 0.043, respectively). Additionally, a high HDAC-2 H-score was significantly associated with longer OS for HG malignant SGT patients (p = 0.027). In our study, HDAC-2 expression is a marker for good prognosis, whereas HDAC-6 expression indicated poor prognosis; thus, an inhibitor of HDAC-6 may be used to improve patients' survival.
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Affiliation(s)
- Despoina Pouloudi
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.P.); (M.M.); (P.S.); (N.T.); (E.D.)
| | - Maria Manou
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.P.); (M.M.); (P.S.); (N.T.); (E.D.)
| | - Panagiotis Sarantis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.P.); (M.M.); (P.S.); (N.T.); (E.D.)
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Nikolaos Tsoukalas
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.P.); (M.M.); (P.S.); (N.T.); (E.D.)
| | - Gerasimos Tsourouflis
- 2nd Department of Propedeutic Surgery, School of Medicine, National and Kapodistrian, University of Athens, 115 27 Athens, Greece;
| | - Eougken Dana
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.P.); (M.M.); (P.S.); (N.T.); (E.D.)
| | - Michalis V. Karamouzis
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | | | - Stamatios Theocharis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (D.P.); (M.M.); (P.S.); (N.T.); (E.D.)
- Department of Pathology, Institut Curie, 75248 Paris, France;
- Correspondence: or ; Tel.: +30-210-7462116; Fax: +30-210-7462157
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Choi SY, Lee E, Kim E, Chung MK, Son YI, Baek CH, Jeong HS. Clinical outcomes of bulky parotid gland cancers: need for self-examination and screening program for early diagnosis of parotid tumors. BMC Cancer 2021; 21:178. [PMID: 33602169 PMCID: PMC7890841 DOI: 10.1186/s12885-021-07902-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/11/2021] [Indexed: 01/15/2023] Open
Abstract
Background Early detection and diagnosis of parotid gland cancer (PGC) are essential to improve clinical outcomes, because Tumor-Node-Metastasis stage at diagnosis is a very strong indicator of prognosis in PGC. Nevertheless, some patients still present with large parotid mass, maybe due to the unawareness or ignorance of their disease. In this study, we aimed to present the clinical outcomes of bulky PGC (defined by a 4 cm cutoff point for T3–4 versus T1–2 tumors), to emphasize the necessity of a self-examination tool for parotid gland tumor. Methods We retrospectively reviewed 60 consecutive cases with bulky (equal to and greater than 4 cm in the longest diameter, determined radiologically) malignant tumors arising from the parotid gland from 1995 to 2016. The clinical and pathological factors were analyzed to identify risk factors for poor outcomes using Cox proportional hazard models. In addition, we designed a self-examination tool for parotid gland tumors, similar to breast self-examination for breast cancer detection. Results Patients with bulky parotid cancer showed 48.9% 5-year and 24.5% 10-year overall survival rates and a 47.9% risk of high-grade malignancy. The common pathological diagnoses were carcinoma ex pleomorphic adenoma (18.3%), adenocarcinoma (16.7%), mucoepidermoid carcinoma (16.7%), salivary duct carcinoma (16.7%), and adenoid cystic carcinoma (11.7%). Survival analyses revealed that tumor size (hazard ratio, HR = 1.262 upon increase of 1 cm, 95% confidence interval, 95%CI 1.059–1.502), lymph node metastasis (HR = 2.999, 95%CI 1.048–8.583), and high tumor grade (HR = 4.148, 95%CI 1.215–14.154) were independent prognostic factors in multivariable analysis. Functional preservation of the facial nerve was possible only in less than half of patients. Conclusion In bulky PGC, lymph node metastasis at diagnosis and high tumor grade indicated poor survival outcomes, and functional outcomes of the facial nerve were suboptimal. Thus, a public effort seems to be necessary to decrease these patients with bulky PGC, and to increase patients’ self-awareness of their disease. As a way of early detection, we proposed a parotid self-examination tool to detect parotid gland tumors at an early stage, which is similar to breast self-examination. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-07902-9.
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Affiliation(s)
- Sung Yong Choi
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunkyu Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eunhye Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, 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, Seoul, Republic of Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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20
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Joshi NP, Broughman JR. Postoperative Management of Salivary Gland Tumors. Curr Treat Options Oncol 2021; 22:23. [PMID: 33560478 DOI: 10.1007/s11864-021-00820-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/26/2022]
Abstract
OPINION STATEMENT Salivary gland tumors represent a heterogeneous group of neoplasms characterized by varied histologies and disease outcomes. Initial treatment for the primary and gross nodal disease is usually surgery. Management of the clinically node-negative neck depends upon the risk of lymph nodal involvement. This is usually determined by the AJCC "T" stage and histology. Both surgery and radiation may be utilized to address the lymph nodes at risk. This is especially important for minor salivary gland tumors. Radiation plays an important role in the adjuvant management of salivary gland tumors by reducing the risk of locoregional recurrence. Certain histologies like adenoid cystic carcinoma have a predilection for neurotropic spread to the skull base. Radiation is particularly important in controlling disease at the skull base. The role of concurrent chemotherapy in the adjuvant treatment of salivary gland tumors is not established and remains an area of active research. Certain histologies like salivary duct carcinoma exhibit readily identifiable molecular targets amenable to targeted therapy. Finally, advanced testing of these tumors using next-generation sequencing can also potentially identify molecular targets amenable to therapy. While useful in the management of metastatic disease, the role of these therapies in the adjuvant setting remains unknown.
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Affiliation(s)
- Nikhil P Joshi
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - James R Broughman
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, USA
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21
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Park YM, Kang MS, Kim DH, Koh YW, Kim SH, Lim JY, Choi EC. Surgical extent and role of adjuvant radiotherapy of surgically resectable, low-grade parotid cancer. Oral Oncol 2020; 107:104780. [PMID: 32442895 DOI: 10.1016/j.oraloncology.2020.104780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 04/18/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Due to the rarity of low-grade parotid gland cancer and the diversity of histologic subtype, its optimal treatment modalities and prognostic factors have not been established yet. In this study, we aimed to identify the prognostic factors and adequate treatment modalities for patients with low-grade parotid gland cancer. METHODS We retrospectively analyzed clinico-pathologic data from 287 patients with low-grade parotid gland cancer from 1999 to 2018. RESULTS Recurrence-free survival, disease-specific survival, and overall survival rates at 10 years were 80.6%, 93.9%, and 84.4%, respectively. Among all patients, 56.1% received surgery alone, and the remaining 43.9% received surgery with adjuvant radiotherapy. Resection margin status and TNM stage were significant unfavorable prognostic factors. In patients with T1-2 tumor, surgical extent (total vs. less-than-total) did not show any significant effect on disease recurrence and patients' survival, and the disease was controlled well if a negative surgical margin was obtained after surgery, even with microscopic clear margin of<1 mm. In patients with adverse pathologic features (positive margin, lymphovascular invasion, perineural invasion, extracapsular nodal spread, T3-4, and N1-3), adjuvant radiotherapy significantly decreased loco-regional recurrence. CONCLUSIONS Oncological outcomes were good in patients with low-grade parotid gland cancer with surgery and radiotherapy. In patients with T1-2 low-grade parotid gland cancer, surgery alone showed good local control rate regardless of the extent of surgery, if a negative surgical margin was obtained after surgery. Adjuvant radiotherapy played a significant role in controlling loco-regional recurrence in patients with adverse pathologic features.
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Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Da Hee Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
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22
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Lee AKF, Cho RHW, Lau EHL, Cheng HK, Wong EWY, Ku PKM, Chan JYK, Yeung ZWC. Mitigation of head and neck cancer service disruption during COVID-19 in Hong Kong through telehealth and multi-institutional collaboration. Head Neck 2020; 42:1454-1459. [PMID: 32357277 PMCID: PMC7267310 DOI: 10.1002/hed.26226] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 12/15/2022] Open
Abstract
The 2019 novel coronavirus disease (COVID‐19) pandemic has been spreading worldwide at an alarming rate. Health‐care workers have been confronted with the challenge of not only treating patients with the virus, but also managing the disruption of health‐care services caused by COVID‐19. In anticipation of outbreak, clinic sessions and operation theater lists have been actively cut back since February 2020 to reduce hospital admissions and clinic attendances. This has severely disrupted health‐care services, leading to accumulating clinic caseload and substantial delays for operations. The head and neck cancer service has been faced with the difficult task of managing the balance between infection risk to health‐care providers and the risk of disease progression from prolonged waiting times. We share our experience in Hong Kong on the mitigation of head and neck cancer service disruption through telehealth and multi‐institution collaboration.
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Affiliation(s)
- Alex K F Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Tseung Kwan O New Territories, Hong Kong
| | - Ryan H W Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Tseung Kwan O New Territories, Hong Kong
| | - Eric H L Lau
- Department of Otorhinolaryngology-Head and Neck Surgery, The Chinese University of Hong Kong, Shatin New Territories, Hong Kong
| | - Hung K Cheng
- Department of Anesthesiology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong
| | - Eddy W Y Wong
- Department of Otorhinolaryngology-Head and Neck Surgery, The Chinese University of Hong Kong, Shatin New Territories, Hong Kong
| | - Peter K M Ku
- Department of Otorhinolaryngology-Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Tseung Kwan O New Territories, Hong Kong
| | - Jason Y K Chan
- Department of Otorhinolaryngology-Head and Neck Surgery, The Chinese University of Hong Kong, Shatin New Territories, Hong Kong
| | - Zenon W C Yeung
- Department of Otorhinolaryngology-Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital, Tseung Kwan O New Territories, Hong Kong
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23
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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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24
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Vartanian JG, Gonçalves Filho J, Kowalski LP, Shah JP, Suárez C, Rinaldo A, De Bree R, Rodrigo JP, Hamoir M, Takes RP, Mäkitie AA, Zbären P, Andreasen S, Poorten VV, Sanabria A, Hellquist H, Robbins KT, Bödeker CC, Silver C, Ferlito A. An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid gland. Expert Rev Anticancer Ther 2019; 19:899-908. [PMID: 31591950 DOI: 10.1080/14737140.2019.1674143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Management of clinically negative neck (cN0) in patients with parotid gland cancer is controversial. Treatment options can include observation, elective neck dissection or elective radiotherapy. Areas covered: We addressed the treatment options for cN0 patients with parotid gland cancer. A literature review was undertaken to determine the optimal management of this group of patients. Expert opinion: Patients with parotid carcinoma and clinically negative neck have various options for their management. The analysis of tumor stage, histology and grade is essential to better define patients at risk for occult lymph node metastasis. These patients can be managed by surgery, radiotherapy or their combination, depending on the presence of risk factors, the moment at which such risk factors are detected, patient-related clinical conditions, medical provider expertise and institutional facilities.
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Affiliation(s)
- Jose Guilherme Vartanian
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center , Sao Paulo , Brazil
| | - Joao Gonçalves Filho
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center , Sao Paulo , Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center , Sao Paulo , Brazil
| | - Jatin P Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo , Oviedo , Spain.,Servicio de Otorrinolaringología, Instituto de Investigación Sanitaria del Principado de Asturias , Oviedo , Spain
| | | | - Remco De Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht , Utrecht , The Netherlands
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Instituto de Oncología de Asturias, University of Oviedo, Centro de Investigación Biomédica en Red de Cáncer , Oviedo , Spain
| | - Marc Hamoir
- Department of Head & Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain , Brussels , Belgium
| | - Robert P Takes
- Department of Otorhinolaryngology - Head and Neck Surgery, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Antti A Mäkitie
- Faculty of Medicine, University of Helsinki, Research Programme in Systems Oncology , Helsinki , Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital , Stockholm , Sweden.,Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Peter Zbären
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital , Berne , Switzerland
| | - Simon Andreasen
- Department of Otolaryngology Head & Neck Surgery and Audiology and Department of Pathology Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.,Department of Otolaryngology and Maxillofacial Surgery, Zealand University Hospital , Køge , Denmark
| | - Vincent Vander Poorten
- Multidisciplinary Salivary Gland Society , Geneva , Switzerland.,Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, section Head and Neck Oncology, University Hospitals Leuven , Leuven , Belgium
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Clinica Vida, Universidad de Antioquia , Medellín , Colombia
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, University of Algarve , Faro , Portugal
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine , Springfield , USA
| | - Carsten C Bödeker
- Department of Otorhinolaryngology-Head and Neck Surgery, HELIOS Hanseklinikum , Stralsund , Germany
| | - Carl Silver
- Department of Surgery, University of Arizona College of Medicine , Phoenix , AZ , USA
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group , Padua , Italy
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25
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Alraddadi T, Aldhahri S, Alharbi J, Malas M, Islam T, Altuwaijri A, Al-Qahtani K. Predictors for Salivary Gland Cancer Recurrence at Two Tertiary Hospitals in Saudi Arabia. Cureus 2019; 11:e5288. [PMID: 31576277 PMCID: PMC6764638 DOI: 10.7759/cureus.5288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Tumors of salivary glands are enlarged as a low-risk mass and mostly benign in nature. The treatment of salivary gland malignancy remains quite challenging because of its relative infrequency, unreliable biological manners, and risk of re-emergence. For effective treatment planning, prediction of factors associated with the recurrence of salivary gland malignancy is essential. Aim The objective of this study was to identify the factors associated with recurrence of salivary gland malignancy at two tertiary hospitals in Saudi Arabia. Material and methods A cross-sectional study was conducted at two tertiary hospitals in Saudi Arabia, where data of patients were recorded from the medical records of hospitals from 2012 to 2018. 63 patients who were diagnosed with salivary gland malignancy, whether originated from parotid, submandibular, sublingual, and minor salivary glands were included in the study. Descriptive statistics are shown in mean, frequency, and percentages, while comparative analysis was done using the Chi-square test, where p < 0.05 is considered significant. Results This study included 63 participants. The majority of malignant salivary gland cancers arise from the parotid gland (47.6%), and mucoepidermoid carcinoma was the commonest form of malignancy in 36.5% of the studied population. Out of 63 patients, 17 had a recurrence of cancer, and the initial advanced stage of the disease is apparently associated with the re-emergence of salivary gland cancer. Conclusion The initial advanced stage of cancer has a significant role in the recurrence of salivary gland malignancy. As salivary gland malignancy is rare and has unreliable behavior, establishing an adequate treatment plan prediction for recurrence is essential.
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Affiliation(s)
| | | | | | - Moayyad Malas
- Otolaryngology, King Khaled Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Tahera Islam
- Miscellaneous, College of Medicine and Research Center, King Saud University, Riyadh, SAU
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26
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Wu WL, Wang CL, Li D, Luo J, Ye JY, Xu SS. Multiphase contrast-enhanced computed tomography imaging features of salivary duct carcinoma: differentiation from other salivary gland malignancies. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:543-551. [PMID: 31277959 DOI: 10.1016/j.oooo.2019.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the imaging features of salivary duct carcinoma (SDC) with multiphase contrast-enhanced computed tomography (CECT) and to compare them with those of mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), and acinic cell carcinoma. STUDY DESIGN A total of 63 patients with histologically diagnosed salivary gland malignancies underwent preoperative multiphase CECT. Clinical information, location, size, mass pattern, enhancement pattern, borders, invasion of adjacent tissues, and lymph node metastasis were evaluated. Computed tomography (CT) number attenuation patterns were calculated. RESULTS SDCs were significantly more common in males and in the parotid gland (P ≤ .018). They were more likely to invade into adjacent tissues and metastasize to lymph nodes (P ≤ .032). Six SDCs (66.7%) had comedonecrosis, as detected on histopathologic examination, and 3 lesions presented cribriform necrosis on CECT. CT numbers during delayed-phase scanning were significantly higher in SDC than in ACC (P = .031). Significant differences were discovered between MEC and ACC for CT numbers during arterial-phase scanning (P = .047) and in the ratio of CT numbers (P = .018). CONCLUSIONS SDC exhibits some specific CT features, and multiphase CECT imaging is useful in the differential diagnosis of salivary gland malignancies.
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Affiliation(s)
- Wen-Li Wu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng-Long Wang
- Department of Pathology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Dan Li
- Department of Pathology, College of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Jin Luo
- Key Laboratory of Optoelectronic Technology and Systems of the Ministry of Education, Chongqing University, Chongqing, China
| | - Jun-Yong Ye
- Key Laboratory of Optoelectronic Technology and Systems of the Ministry of Education, Chongqing University, Chongqing, China
| | - Sheng-Sheng Xu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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27
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Park W, Park J, Park SI, Kim H, Bae H, Cho J, Won H, Park M, Jeong HS. Clinical outcomes and management of facial nerve in patients with parotid gland cancer and pretreatment facial weakness. Oral Oncol 2019; 89:144-149. [DOI: 10.1016/j.oraloncology.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 12/28/2018] [Accepted: 01/06/2019] [Indexed: 10/27/2022]
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28
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Park W, Bae H, Park MH, Hwang NY, Sohn I, Cho J, Jeong HS. Risk of high-grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology. J Oral Pathol Med 2019; 48:222-231. [PMID: 30576028 DOI: 10.1111/jop.12816] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/30/2018] [Accepted: 12/18/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Milan System for Reporting Salivary Gland Cytopathology (Milan System) has previously shown its diagnostic utility by categorizing the seven cytology findings in salivary gland lesions. However, there has been lack of study about the risk of high-grade malignancy in the cytology diagnosis based on the Milan System. Thus, we tried to identify the diagnostic ability of the Milan System for high-grade malignancy and to suggest an improved diagnostic approach for preoperative estimation of high-grade malignancy using the Milan System. METHODS A total of 413 patients with parotid gland tumors, who had undergone surgical resection from 2011 to 2015 were included in the present study retrospectively. Cytopathology was reclassified according to the Milan System by two independent reviewers. The outcomes were risk of malignancy and risk of high-grade malignancy. The diagnostic performance of the Milan System category [Malignant] for detecting high-grade malignancy was calculated. RESULTS The risk of malignancy was 83.3% and 100% in the Milan System categories [Suspicious for Malignancy] and [Malignant], respectively. Meanwhile, the risk of high-grade malignancy was 16.7% and 55.9% in these two categories. Disease-free survival of patients with high-grade malignancy was significantly worse than those with low- and intermediate-grade malignancy. Union combining the Milan System category [Malignant] with the presence of nodal metastasis suggested high-grade malignancy with an acceptable diagnostic sensitivity (0.889-0.963) and negative predictive value (0.900-0.966). CONCLUSIONS The Milan System category [Malignant] with the presence of nodal metastasis suggested parotid gland tumors as high-grade malignancy in a pretreatment setting.
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Affiliation(s)
- Woori Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyunsik Bae
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min-Hae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Na Young Hwang
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Insuk Sohn
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Junhun Cho
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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