Prognostic factors in surgically treated malignant salivary gland tumors

Elena Hofmann; Janine Priebe; Damian Tobias Rieke; Christian Doll; Annekatrin Coordes; Heidi Olze; Veit M Hofmann; Max Heiland; Benedicta Beck-Broichsitter

doi:10.1016/j.oraloncology.2023.106484

Prognostic factors in surgically treated malignant salivary gland tumors

Oral Oncol. 2023 Sep:144:106484. doi: 10.1016/j.oraloncology.2023.106484. Epub 2023 Jul 6.

Authors

Elena Hofmann¹, Janine Priebe², Damian Tobias Rieke³, Christian Doll², Annekatrin Coordes⁴, Heidi Olze⁵, Veit M Hofmann⁶, Max Heiland², Benedicta Beck-Broichsitter⁷

Affiliations

¹ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Junior Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: elena.hofmann@charite.de.
² Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
³ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Comprehensive Cancer Center, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany.
⁴ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Campus Virchow Klinikum/ Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; University Medical Centre Ruppin Brandenburg, Brandenburg Medical School, Department of Otorhinolaryngology, Head and Neck Surgery, Fehrbelliner Straße 38, 16816 Neuruppin, Germany; Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Joint Faculty of the University of Potsdam, Faculty of Health Sciences Brandenburg, Am Neuen Palais 10, House 9, 14469 Potsdam, Germany.
⁵ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Campus Virchow Klinikum/ Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany.
⁶ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
⁷ Katharinenhospital Klinikum Stuttgart, Department of Oral and Maxillofacial Surgery, Kriegsbergstraße 60, 70174 Stuttgart, Germany.

PMID: 37421674
DOI: 10.1016/j.oraloncology.2023.106484

Abstract

Objectives: To identify prognostic factors for evidence-based risk stratification in malignant salivary gland tumors.

Methods: This retrospective study identified 162 patients who presented with malignant salivary gland tumors between 2010 and 2020. Final analysis included 91 patients who underwent surgical treatment at our institution and were followed-up for ≥ 1 year. Medical records were reviewed and patients were categorized according to their risk profile.

Results: This study included 91 patients (51 males, 40 females, mean age 61 years). The most frequent entities were adenoid cystic carcinoma (n = 13, 14.3%) and mucoepidermoid carcinoma (n = 12, 13.2%). Kaplan-Meier analysis demonstrated a five-year overall survival (OS) of 66.2% and a recurrence-free survival (RFS) of 50.5%. Age > 60 years (p = 0.011), categorization into high-risk group (p = 0.011), UICC stage (p = 0.020), T stage (p = 0.032), grading (p = 0.045) and vascular invasion (p < 0.001) were significantly associated with OS; age > 60 years (p = 0.014), categorization into high-risk group (p < 0.001), UICC stage (p = 0.021), T stage (p = 0.017), grading (p = 0.011), vascular invasion (p = 0.012) and lymphovascular invasion (p < 0.001) were significantly associated with RFS. Multivariate Cox regression with backward elimination identified T stage (HR 1.835; 95% CI 1.187-2.836; p = 0.006) and grading (HR 2.233; 95% CI 1.113-4.480; p = 0.024) as significant factors for OS. Grading (HR 2.499; 95% CI 1.344-4.648; p = 0.004) was confirmed as a significant factor for RFS.

Conclusion: Considering the risk of recurrence and distant metastasis in malignant salivary gland tumors, locoregional surgical control may not be sufficient and adjuvant therapies such as radiotherapy and/or systemic therapies should be considered.

Keywords: Head and neck cancer; Malignant salivary tumors; Prognosis; Surgery; Therapy.

MeSH terms

Carcinoma, Adenoid Cystic* / pathology
Combined Modality Therapy
Female
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Salivary Gland Neoplasms* / pathology
Survival Rate