Epidemiology, outcomes, and prognostic factors in submandibular gland carcinomas: a national DAHANCA study

Eur Arch Otorhinolaryngol. 2023 Jul;280(7):3405-3413. doi: 10.1007/s00405-023-07940-y. Epub 2023 Apr 13.

Abstract

Purpose: The aim of this study is to present incidence, histological subtypes, survival rates, and prognostic factors based on a national cohort of patients with salivary gland carcinoma.

Methods: All Danish patients with submandibular gland carcinoma diagnosed from 1990 to 2015 (n = 206) were included and analyzed following histological re-evaluation. Data were collected by the Danish Head and Neck Cancer Group (DAHANCA). Overall, disease-specific and recurrence-free survival were evaluated. Prognostic factors were analyzed with multivariate Cox Hazard Regression.

Results: The study population consisted of 109 (53%) men and 97 (47%) women, median age 62 years (range 11-102). Adenoid cystic carcinoma was the most frequent subtype (50%). Tumour classification T1/T2 (75%) and N0 (78%) was most frequent. The mean crude incidence was 0.17/100,000/year. Most patients (n = 194, 94%) were treated with primary surgery, and 130 (67%) received postoperative radiotherapy. The 5- and 10-year survival rates were for overall survival 64% and 41%, disease-specific survival 74% and 61%, and recurrence-free survival 70% and 56%, respectively. Survival rates were higher for adenoid cystic carcinoma compared to other subtypes, but the difference was not significant in multivariate analysis. Recurrence occurred in 69 patients, and 37 (53.6%) of them had recurrence in a distant site. Advanced T-classification and regional lymph-node metastases had significant negative impact on survival rates.

Conclusion: The incidence of submandibular gland carcinoma in Denmark was 0.17/100,000/year and stable during the time period. The most frequent subtype was adenoid cystic carcinoma. Half of the recurrences presented in a distant site, and multivariate analysis confirmed that advanced stage was independent negative prognostic factor for recurrence and survival.

Keywords: Salivary gland carcinoma; Submandibular gland cancer; Submandibular gland carcinoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Adenoid Cystic* / epidemiology
  • Carcinoma, Adenoid Cystic* / therapy
  • Child
  • Female
  • Head and Neck Neoplasms*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Prognosis
  • Retrospective Studies
  • Salivary Gland Neoplasms* / epidemiology
  • Salivary Gland Neoplasms* / therapy
  • Submandibular Gland
  • Survival Rate
  • Young Adult