Skip to main content

Advertisement

SpringerLink
Log in

Clinical value of adjuvant therapy on the prognosis of ductal carcinoma of the major salivary gland: a large-scale cohort study

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To explore the clinical characteristics, prognostic factors, and value of adjuvant therapy for major salivary duct carcinoma (SDC).

Methods

Data of SDC patients who received surgery was obtained from Surveillance, Epidemiology, and End Results (SEER) database (2004–2016). Kaplan–Meier and Cox regression analyses were performed to assess prognostic factors. Propensity score matching (PSM) was done to evaluate the clinical value of adjuvant therapy.

Results

A total of 287 patients were enrolled. The 5-year overall survival (OS) and disease-specific survival (DSS) rates were 53.8% and 70.8%, respectively. In the univariate analysis, tumor size, T, N, TNM staging, SEER combined staging, number of regional lymph nodes examined, and number of positive lymph nodes were associated with OS and DSS. Age and primary surgical methods were also related to OS. Among patients with negative lymph nodes, patients with tumor size > 4 cm had significantly worse prognosis (P = 0.009). Multivariate analysis showed that age > 75 years, T3–4, and positive lymph nodes were independent risk factors for SDC. After PSM, the prognostic factors were age, tumor site, and T and N stage. Postoperative radiotherapy could improve OS in patients with tumor size > 4 cm (P = 0.049).

Conclusions

Advanced age, submandibular gland lesions, T3–4 stage, and lymph node involvement were independent prognostic factors for SDC. In patients with tumors > 4 cm, adjuvant radiotherapy improved the OS of SDC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of data and materials

Not available.

Abbreviations

SDC:

Salivary duct carcinoma

SGCs:

Salivary gland cancers

SEER:

Surveillance, epidemiology, and end results

PSM:

Propensity score matching

OS:

Overall survival

DSS:

Disease-specific survival

HR:

Risk ratio

CI:

Confidence interval

PSM:

Propensity score matching

References

  1. Laurie SA, Licitra L (2006) Systemic therapy in the palliative management of advanced salivary gland cancers. J Clin Oncol 24(17):2673–2678. https://doi.org/10.1200/jco.2005.05.3025

    Article  CAS  Google Scholar 

  2. Rahman M, Griffith CC (2021) Salivary duct carcinoma: an aggressive salivary gland carcinoma with morphologic variants, newly identified molecular characteristics, and emerging treatment modalities. Surg Pathol Clin 14(1):111–126. https://doi.org/10.1016/j.path.2020.09.010

    Article  Google Scholar 

  3. Keller G, Steinmann D, Quaas A, Grünwald V, Janssen S, Hussein K (2017) New concepts of personalized therapy in salivary gland carcinomas. Oral Oncol 68:103–113. https://doi.org/10.1016/j.oraloncology.2017.02.018

    Article  CAS  Google Scholar 

  4. Nakaguro M, Tada Y, Faquin WC, Sadow PM, Wirth LJ, Nagao T (2020) Salivary duct carcinoma: updates in histology, cytology, molecular biology, and treatment. Cancer Cytopathol 128(10):693–703. https://doi.org/10.1002/cncy.22288

    Article  CAS  Google Scholar 

  5. Park YM, Kang MS, Kim DH, Koh YW, Kim SH, Lim JY, Choi EC (2020) Surgical extent and role of adjuvant radiotherapy of surgically resectable, low-grade parotid cancer. Oral Oncol 107:104780. https://doi.org/10.1016/j.oraloncology.2020.104780

    Article  CAS  Google Scholar 

  6. Fitzpatrick PJ, Theriault C (1986) Malignant salivary gland tumors. Int J Radiat Oncol Biol Phys 12(10):1743–1747. https://doi.org/10.1016/0360-3016(86)90314-7

    Article  CAS  Google Scholar 

  7. Renehan AG, Gleave EN, Slevin NJ, McGurk M (1999) Clinico-pathological and treatment-related factors influencing survival in parotid cancer. Br J Cancer 80(8):1296–1300. https://doi.org/10.1038/sj.bjc.6990501

    Article  CAS  Google Scholar 

  8. Terhaard CH, Lubsen H, Rasch CR, Levendag PC, Kaanders HH, Tjho-Heslinga RE, van Den Ende PL, Burlage F (2005) The role of radiotherapy in the treatment of malignant salivary gland tumors. Int J Radiat Oncol Biol Phys 61(1):103–111. https://doi.org/10.1016/j.ijrobp.2004.03.018

    Article  Google Scholar 

  9. Terhaard CH, Lubsen H, Van der Tweel I, Hilgers FJ, Eijkenboom WM, Marres HA, Tjho-Heslinga RE, de Jong JM, Roodenburg JL (2004) Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck 26(8):681–692. https://doi.org/10.1002/hed.10400

    Article  Google Scholar 

  10. Stodulski D, Mikaszewski B, Majewska H, Kuczkowski J (2019) Parotid salivary duct carcinoma: a single institution’s 20-year experience. Eur Arch Otorhinolaryngol 276(7):2031–2038. https://doi.org/10.1007/s00405-019-05454-0

    Article  Google Scholar 

  11. Kantamani D, Bandaru SS, Miatech JL, Stagg MP (2021) Salivary duct carcinoma: case reports and brief review of the literature. Case Rep Oncol Med. https://doi.org/10.1155/2021/2672772

    Article  Google Scholar 

  12. Haderlein M, Scherl C, Semrau S, Lettmaier S, Hecht M, Erber R, Iro H, Fietkau R, Agaimy A (2017) Impact of postoperative radiotherapy and HER2/new overexpression in salivary duct carcinoma: a monocentric clinicopathologic analysis. Strahlenther Onkol 193(11):961–970. https://doi.org/10.1007/s00066-017-1196-8

    Article  Google Scholar 

  13. Salovaara E, Hakala O, Bäck L, Koivunen P, Saarilahti K, Passador-Santos F, Leivo I, Mäkitie AA (2013) Management and outcome of salivary duct carcinoma in major salivary glands. Eur Arch Otorhinolaryngol 270(1):281–285. https://doi.org/10.1007/s00405-012-1997-4

    Article  Google Scholar 

  14. Breinholt H, Elhakim MT, Godballe C, Andersen LJ, Primdahl H, Kristensen CA, Bjørndal K (2016) Salivary duct carcinoma: a Danish national study. J Oral Pathol Med 45(9):664–671. https://doi.org/10.1111/jop.12426

    Article  CAS  Google Scholar 

  15. Jayaprakash V, Merzianu M, Warren GW, Arshad H, Hicks WL Jr, Rigual NR, Sullivan MA, Seshadri M, Marshall JR, Cohan DM, Zhao Y, Singh AK (2014) Survival rates and prognostic factors for infiltrating salivary duct carcinoma: analysis of 228 cases from the Surveillance, Epidemiology, and End Results database. Head Neck 36(5):694–701. https://doi.org/10.1002/hed.23350

    Article  Google Scholar 

  16. El-Naggar AK, Chan JK, Grandis JR (2017) WHO classification of head and neck tumours

  17. Villepelet A, Lefèvre M, Verillaud B, Janot F, Garrel R, Vergez S, Bertolus C, Malard O, de Gabory L, Mauvais O, Baujat B (2019) Salivary duct carcinoma: prospective multicenter study of 61 cases of the Réseau d’Expertise Français des Cancers ORL Rares. Head Neck 41(3):584–591. https://doi.org/10.1002/hed.25194

    Article  Google Scholar 

  18. Boon E, Bel M, van Boxtel W, van der Graaf WTA, van Es RJJ, Eerenstein SEJ, Baatenburg de Jong RJ, van den Brekel MWM, van der Velden LA, Witjes MJH, Hoeben A, Willems SM, Bloemena E, Smit LA, Oosting SF, Jonker MA, Flucke UE, van Herpen CML (2018) A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands. Int J Cancer 143(4):758–766. https://doi.org/10.1002/ijc.31353

    Article  CAS  Google Scholar 

  19. Otsuka K, Imanishi Y, Tada Y, Kawakita D, Kano S, Tsukahara K, Shimizu A, Ozawa H, Okami K, Sakai A, Sato Y, Ueki Y, Sato Y, Hanazawa T, Chazono H, Ogawa K, Nagao T (2016) Clinical outcomes and prognostic factors for salivary duct carcinoma: a multi-institutional analysis of 141 patients. Ann Surg Oncol 23(6):2038–2045. https://doi.org/10.1245/s10434-015-5082-2

    Article  Google Scholar 

  20. Mahmood U, Koshy M, Goloubeva O, Suntharalingam M (2011) Adjuvant radiation therapy for high-grade and/or locally advanced major salivary gland tumors. Arch Otolaryngol Head Neck Surg 137(10):1025–1030. https://doi.org/10.1001/archoto.2011.158

    Article  Google Scholar 

  21. Lewis AG, Tong T, Maghami E (2016) Diagnosis and management of malignant salivary gland tumors of the parotid gland. Otolaryngol Clin North Am 49(2):343–380. https://doi.org/10.1016/j.otc.2015.11.001

    Article  Google Scholar 

  22. Haderlein M, Scherl C, Semrau S, Lettmaier S, Hecht M, Putz F, Iro H, Agaimy A, Fietkau R (2019) Salivary gland carcinoma (SGC) with perineural spread and/or positive resection margin—high locoregional control rates after photon (chemo) radiotherapy—experience from a monocentric analysis. Radiat Oncol 14(1):68. https://doi.org/10.1186/s13014-019-1260-x

    Article  Google Scholar 

  23. Lee DS, Lee CG, Keum KC, Chung SY, Kim T, Wu HG, Kim JH, Sung MW, Ahn SH, Cho KH, Kang KM, Oh YT, Kim JH, Kang MK (2020) Treatment outcomes of patients with salivary duct carcinoma undergoing surgery and postoperative radiotherapy. Acta Oncol 59(5):565–568. https://doi.org/10.1080/0284186x.2020.1730005

    Article  Google Scholar 

  24. Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH, Giralt J, Maingon P, Rolland F, Bolla M, Cognetti F, Bourhis J, Kirkpatrick A, van Glabbeke M (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350(19):1945–1952. https://doi.org/10.1056/NEJMoa032641

    Article  CAS  Google Scholar 

  25. Schoenfeld JD, Sher DJ, Norris CM Jr, Haddad RI, Posner MR, Balboni TA, Tishler RB (2012) Salivary gland tumors treated with adjuvant intensity-modulated radiotherapy with or without concurrent chemotherapy. Int J Radiat Oncol Biol Phys 82(1):308–314. https://doi.org/10.1016/j.ijrobp.2010.09.042

    Article  Google Scholar 

  26. Cho JK, Lim BW, Kim EH, Ko YH, Oh D, Noh JM, Ahn YC, Baek KH, Jeong HS (2016) Low-grade salivary gland cancers: treatment outcomes, extent of surgery and indications for postoperative adjuvant radiation therapy. Ann Surg Oncol 23(13):4368–4375. https://doi.org/10.1245/s10434-016-5353-6

    Article  Google Scholar 

  27. Tanvetyanon T, Fisher K, Caudell J, Otto K, Padhya T, Trotti A (2016) Adjuvant chemoradiotherapy versus with radiotherapy alone for locally advanced salivary gland carcinoma among older patients. Head Neck 38(6):863–870. https://doi.org/10.1002/hed.24172

    Article  Google Scholar 

  28. Cheraghlou S, Schettino A, Zogg CK, Otremba MD, Bhatia A, Park HS, Osborn HA, Mehra S, Yarbrough WG, Judson BL (2019) Adjuvant chemotherapy is associated with improved survival for late-stage salivary squamous cell carcinoma. Laryngoscope 129(4):883–889. https://doi.org/10.1002/lary.27444

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors acknowledge the efforts of the SEER Program tumor registries in the creation of the SEER database and thank all the patients analyzed in this study.

Funding

None to declare.

Author information

Author notes

  1. Di Zhang and Lixi Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Panjiayuan nan Road 17, Beijing, 100021, China

    Di Zhang, Lixi Li, Tingyu Wen & Fei Ma

Authors
  1. Di Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lixi Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tingyu Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fei Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors conceived and designed the study. DZ and LL analyzed data and wrote the paper, and FM make suggestion and revised the paper. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Fei Ma.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Not available.

Consent for publication

Yes.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 The flow chat. (PDF 85 KB)

405_2022_7599_MOESM2_ESM.pdf

Supplementary file2 Positive lymph nodes and survival in SDC patients. a: Positive regional lymph nodes are plotted against the total number of regional lymph nodes in SDC who underwent neck dissection; b: Relationship between tumor size, tumor grade, and lymph node involvement; c, d: Kaplan–Meier estimate for OS and DSS. d (PDF 106 KB)

Supplementary file3 Comparison of patient characteristics after propensity score matching. (DOCX 25 KB)

405_2022_7599_MOESM4_ESM.docx

Supplementary file4 Univariate and multivariate analyses for OS after PSM in the surgery alone and postoperative radiotherapy groups. (DOCX 18 KB)

405_2022_7599_MOESM5_ESM.docx

Supplementary file5 Univariate and multivariate analyses for OS after PSM in the postoperative radiotherapy and postoperative chemoradiotherapy groups. (DOCX 18 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, D., Li, L., Wen, T. et al. Clinical value of adjuvant therapy on the prognosis of ductal carcinoma of the major salivary gland: a large-scale cohort study. Eur Arch Otorhinolaryngol 280, 409–417 (2023). https://doi.org/10.1007/s00405-022-07599-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-022-07599-x

Keywords

Search

Navigation