Long-term outcomes of surgery followed by radiation therapy for minor salivary gland carcinomas

Youssef Zeidan, David B. Shultz, James D. Murphy, Yi An, Cato Chan, Michael J. Kaplan, A. Dimitrios Colevas, Christina Kong, Daniel T. Chang, Quynh Thu Le

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives/Hypothesis Postoperative radiation therapy is often used in patients with high-risk salivary gland carcinomas. In this study we evaluated the outcomes and prognostic factors in patients with minor salivary gland cancers treated with adjuvant radiation therapy. Study Design Retrospective cohort study. Methods We performed a retrospective analysis of 90 patients treated with curative intent. Median follow-up was 71 months. Fifty-eight patients (64%) had adenoid cystic carcinomas, 22 (24%) had adenocarcinomas, and 10 (11%) had mucoepidermoid cancers. Primary disease site included 39 (43%) sinonasal, 35 (39%) oral cavity, 10 (11%) oropharynx, and six (7%) others. Twenty-seven patients (30%) were treated with intensity-modulated radiation therapy. Results Eight local, four neck, and 24 distant relapses were detected. Local control rates at 5 and 10 years were 90% and 88%, respectively. Advanced T stage was associated with worse local control. Distant metastasis rates were 24% and 28% at 5 and 10 years, respectively. Tumor stage, histology, perineural invasion, and lymphovascular space invasion were significant predictors of distant metastasis on univariate analysis. However, on multivariate analysis only the American Joint Committee on Cancer stage was significant. Overall survival rates were 76% and 63% at 5 and 10 years, respectively. More advanced T stage and N stage correlated with worse overall survival. Conclusions Tumor stage remains the best predictor for locoregional and distant disease control of minor salivary gland cancers. Postoperative radiation therapy for high-risk patients results in excellent long-term locoregional disease control. Further work is needed to improve systemic control.

Original languageEnglish (US)
Pages (from-to)2675-2680
Number of pages6
JournalLaryngoscope
Volume123
Issue number11
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Minor Salivary Glands
Radiotherapy
Carcinoma
Salivary Gland Neoplasms
Neoplasms
Neoplasm Metastasis
Adenoid Cystic Carcinoma
Oropharynx
Salivary Glands
Mouth
Histology
Adenocarcinoma
Cohort Studies
Neck
Multivariate Analysis
Survival Rate
Retrospective Studies
Outcome Assessment (Health Care)
Recurrence
Survival

Keywords

  • head and neck
  • Minor salivary gland
  • postoperative
  • radiotherapy
  • toxicity

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Zeidan, Y., Shultz, D. B., Murphy, J. D., An, Y., Chan, C., Kaplan, M. J., ... Le, Q. T. (2013). Long-term outcomes of surgery followed by radiation therapy for minor salivary gland carcinomas. Laryngoscope, 123(11), 2675-2680. https://doi.org/10.1002/lary.24081

Long-term outcomes of surgery followed by radiation therapy for minor salivary gland carcinomas. / Zeidan, Youssef; Shultz, David B.; Murphy, James D.; An, Yi; Chan, Cato; Kaplan, Michael J.; Colevas, A. Dimitrios; Kong, Christina; Chang, Daniel T.; Le, Quynh Thu.

In: Laryngoscope, Vol. 123, No. 11, 11.2013, p. 2675-2680.

Research output: Contribution to journalArticle

Zeidan, Y, Shultz, DB, Murphy, JD, An, Y, Chan, C, Kaplan, MJ, Colevas, AD, Kong, C, Chang, DT & Le, QT 2013, 'Long-term outcomes of surgery followed by radiation therapy for minor salivary gland carcinomas', Laryngoscope, vol. 123, no. 11, pp. 2675-2680. https://doi.org/10.1002/lary.24081
Zeidan Y, Shultz DB, Murphy JD, An Y, Chan C, Kaplan MJ et al. Long-term outcomes of surgery followed by radiation therapy for minor salivary gland carcinomas. Laryngoscope. 2013 Nov;123(11):2675-2680. https://doi.org/10.1002/lary.24081
Zeidan, Youssef ; Shultz, David B. ; Murphy, James D. ; An, Yi ; Chan, Cato ; Kaplan, Michael J. ; Colevas, A. Dimitrios ; Kong, Christina ; Chang, Daniel T. ; Le, Quynh Thu. / Long-term outcomes of surgery followed by radiation therapy for minor salivary gland carcinomas. In: Laryngoscope. 2013 ; Vol. 123, No. 11. pp. 2675-2680.
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abstract = "Objectives/Hypothesis Postoperative radiation therapy is often used in patients with high-risk salivary gland carcinomas. In this study we evaluated the outcomes and prognostic factors in patients with minor salivary gland cancers treated with adjuvant radiation therapy. Study Design Retrospective cohort study. Methods We performed a retrospective analysis of 90 patients treated with curative intent. Median follow-up was 71 months. Fifty-eight patients (64{\%}) had adenoid cystic carcinomas, 22 (24{\%}) had adenocarcinomas, and 10 (11{\%}) had mucoepidermoid cancers. Primary disease site included 39 (43{\%}) sinonasal, 35 (39{\%}) oral cavity, 10 (11{\%}) oropharynx, and six (7{\%}) others. Twenty-seven patients (30{\%}) were treated with intensity-modulated radiation therapy. Results Eight local, four neck, and 24 distant relapses were detected. Local control rates at 5 and 10 years were 90{\%} and 88{\%}, respectively. Advanced T stage was associated with worse local control. Distant metastasis rates were 24{\%} and 28{\%} at 5 and 10 years, respectively. Tumor stage, histology, perineural invasion, and lymphovascular space invasion were significant predictors of distant metastasis on univariate analysis. However, on multivariate analysis only the American Joint Committee on Cancer stage was significant. Overall survival rates were 76{\%} and 63{\%} at 5 and 10 years, respectively. More advanced T stage and N stage correlated with worse overall survival. Conclusions Tumor stage remains the best predictor for locoregional and distant disease control of minor salivary gland cancers. Postoperative radiation therapy for high-risk patients results in excellent long-term locoregional disease control. Further work is needed to improve systemic control.",
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AB - Objectives/Hypothesis Postoperative radiation therapy is often used in patients with high-risk salivary gland carcinomas. In this study we evaluated the outcomes and prognostic factors in patients with minor salivary gland cancers treated with adjuvant radiation therapy. Study Design Retrospective cohort study. Methods We performed a retrospective analysis of 90 patients treated with curative intent. Median follow-up was 71 months. Fifty-eight patients (64%) had adenoid cystic carcinomas, 22 (24%) had adenocarcinomas, and 10 (11%) had mucoepidermoid cancers. Primary disease site included 39 (43%) sinonasal, 35 (39%) oral cavity, 10 (11%) oropharynx, and six (7%) others. Twenty-seven patients (30%) were treated with intensity-modulated radiation therapy. Results Eight local, four neck, and 24 distant relapses were detected. Local control rates at 5 and 10 years were 90% and 88%, respectively. Advanced T stage was associated with worse local control. Distant metastasis rates were 24% and 28% at 5 and 10 years, respectively. Tumor stage, histology, perineural invasion, and lymphovascular space invasion were significant predictors of distant metastasis on univariate analysis. However, on multivariate analysis only the American Joint Committee on Cancer stage was significant. Overall survival rates were 76% and 63% at 5 and 10 years, respectively. More advanced T stage and N stage correlated with worse overall survival. Conclusions Tumor stage remains the best predictor for locoregional and distant disease control of minor salivary gland cancers. Postoperative radiation therapy for high-risk patients results in excellent long-term locoregional disease control. Further work is needed to improve systemic control.

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