Outcomes and prognostic factors in modern era management of major salivary gland cancer
| Autor: | Jonathan J. Beitler, N. Jegadeesh, Yuan Liu, Roshan S. Prabhu, J. Trad Wadsworth, Kristin Higgins, David M. Marcus, Kelly R. Magliocca, Jeffrey M. Vainshtein |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Disease Article Young Adult Risk Factors Major Salivary Gland Internal medicine medicine Adjuvant therapy Humans Aged Retrospective Studies Aged 80 and over business.industry Head and neck cancer Cancer Middle Aged Prognosis Salivary Gland Neoplasms medicine.disease Survival Analysis Surgery Survival Rate Radiation therapy Salivary gland cancer T-stage Female Neoplasm Recurrence Local Oral Surgery business |
| Zdroj: | Oral Oncology. 51:770-777 |
| ISSN: | 1368-8375 |
| DOI: | 10.1016/j.oraloncology.2015.05.005 |
| Popis: | There is a dearth of prospective evidence regarding cancer of the major salivary glands. Outcomes and management of major salivary gland are based largely on retrospective series spanning many decades and changes in surgical, radiation, imaging and systemic therapy strategies and technique. We sought to report contemporary patterns of relapse and prognostic factors for major salivary gland cancer.112 patients with major salivary gland cancers underwent resection with or without adjuvant therapy between January 1997 and September 2010. Outcomes were documented with follow-up until December 2014. Survival was calculated by the Kaplan-Meier method. Log-rank test and Cox proportional hazards regression were performed with locoregional control (LRC), distant control (DC) and overall survival (OS) as the primary outcome variables.Median follow-up was 55.1 months. Rates of LRC for stage I/II and III/IV at five years were 95.7% and 61.9% respectively. Rates of DC at five years for stage I/II and III/IV were 93% and 56.9% respectively. Multivariate analysis identified larger tumor size, clinical nerve involvement and in parotid cancers, advanced T stage, no adjuvant radiation, and older age at diagnosis to be associated with increased risk of locoregional recurrence (all p0.05). Distant metastasis was associated with sublingual site, degree of clinical nerve involvement, high grade, tumor size and in parotid tumors additionally deep lobe involvement on multivariate analysis (all p0.05).Several prognostic factors were identified that may help guide decisions regarding adjuvant therapy. DM remains a significant concern in the management of this disease. |
| Databáze: | OpenAIRE |
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