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Low-Grade Salivary Gland Cancers: Treatment Outcomes, Extent of Surgery and Indications for Postoperative Adjuvant Radiation Therapy

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Histologic grade of tumor is one of the major prognostic predictors for patients with salivary gland cancer. Because of disease rarity, little is known about the optimal treatment modalities and outcomes in low-grade salivary gland cancers (LGSGC). We tried to identify prognostic factors, and the adequate treatment modalities and outcomes in pathologically confirmed LGSGC patients.

Methods

We retrospectively extracted the clinical and pathology data from 179 LGSGC cases from 1995 to 2013. Pathological features, such as extraparenchymal extension, perineural/nerve invasion, lymphovascular invasion/tumor emboli, and resection margin status were redefined for each case. Risk factors for recurrence, extent of surgery, and the role of postoperative radiation therapy were analyzed.

Results

Recurrence-free survival and overall survival were 89.6 and 96.6 % at 10 years, respectively. The presence of regional nodal metastasis and positive cancer cells at resection margin were significant unfavorable prognostic factors. Postoperative adjuvant radiation treatment significantly reduced recurrences, particularly in cases with pathology risk factors (perineural invasion, lymphovascular invasion, extraparenchymal extension, or cancer cells at the resection margin), node metastasis, and advanced T-stage tumors. Close surgical margin <5 mm was not a significant risk factor for recurrence, and less-than-total resection of the affected gland did not increase recurrence, if surgery could achieve a cancer cell-free surgical margin.

Conclusion

Postoperative radiation clearly benefitted patients with pathology risk factors, node metastasis, and advanced T stage in LGSGC. Meanwhile, the oncological outcomes are very good with surgery alone in cases of pT1-2N0 LGSGC without pathology risk factors.

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Acknowledgment

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST; 2015R1D1A1A09056771) and the Samsung Biomedical Research Institute (SBRI) 2016 basic-clinical collaborative research grant.

Funding

The above funders had no further role in the study design, collection, analysis and interpretation of data, writing of the manuscript, or in the decision to submit this manuscript for publication.

Conflict of interest

Jae-Keun Cho, Byung-Woo Lim, Eun-Hye Kim, Young-Hyeh Ko, Dongryul Oh, Jae-Myoung Noh, Yong Chan Ahn, Kwan-Hyuck Baek, and Han-Sin Jeong have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Otorhinolaryngology–Head and Neck Surgery, Inje University Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Republic of Korea

    Jae-Keun Cho MD & Byung-Woo Lim MD

  2. Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Eun-Hye Kim RN & Han-Sin Jeong MD, PhD

  3. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Young-Hyeh Ko MD, PhD

  4. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Dongryul Oh MD, Jae-Myoung Noh MD & Yong Chan Ahn MD, PhD

  5. Department of Molecular and Cellular Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Gyeonggi, Republic of Korea

    Kwan-Hyuck Baek PhD

Authors
  1. Jae-Keun Cho MD
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  2. Byung-Woo Lim MD
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  3. Eun-Hye Kim RN
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  4. Young-Hyeh Ko MD, PhD
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  5. Dongryul Oh MD
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  6. Jae-Myoung Noh MD
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  7. Yong Chan Ahn MD, PhD
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  8. Kwan-Hyuck Baek PhD
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  9. Han-Sin Jeong MD, PhD
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Corresponding authors

Correspondence to Kwan-Hyuck Baek PhD or Han-Sin Jeong MD, PhD.

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Cho, JK., Lim, BW., Kim, EH. et al. Low-Grade Salivary Gland Cancers: Treatment Outcomes, Extent of Surgery and Indications for Postoperative Adjuvant Radiation Therapy. Ann Surg Oncol 23, 4368–4375 (2016). https://doi.org/10.1245/s10434-016-5353-6

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  • DOI: https://doi.org/10.1245/s10434-016-5353-6

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