Pathological nodal status as a main predictive factor of survival and treatment outcomes of submandibular salivary gland cancers: A 25-year single center experience

Denis Brajkovic; Aleksandar Kiralj; Ivana Mijatov; Miroslav Ilic

doi:10.1016/j.jormas.2023.101462

Pathological nodal status as a main predictive factor of survival and treatment outcomes of submandibular salivary gland cancers: A 25-year single center experience

J Stomatol Oral Maxillofac Surg. 2023 Dec;124(6):101462. doi: 10.1016/j.jormas.2023.101462. Epub 2023 Mar 30.

Authors

Denis Brajkovic¹, Aleksandar Kiralj², Ivana Mijatov², Miroslav Ilic²

Affiliations

¹ Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Novi Sad, Serbia; Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia. Electronic address: denis.brajkovic@mf.uns.ac.rs.
² Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Novi Sad, Serbia; Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia.

PMID: 37003413
DOI: 10.1016/j.jormas.2023.101462

Abstract

Introduction: Aim of this study was to explore the survival predictive factors and treatment outcomes in a cohort of SGC patients treated at a single center over a period of 25 years.

Materials and methods: Patients who had received primary treatment for SGC were enroled. Outcomes evaluated were: overall survival (OS), disease specific survival (DSS), recurrence free survival (RFS), locoregional recurrence free survival (LRFS) and distant metastasis free survival (DFS).

Results: A total of 40 patients with SGC were enroled in the study. The most common tumor was the adenoid cystic carcinoma (60% of cases). Cumulative OS for 5-and 10-year follow up period was 81% and 60%, respectively. Thirteen patients (32.5%) developed distant metastases during follow-up. Nodal status, high-grade histology, tumor stage and adjuvant radiation-therapy (RT) were significant variables on multivariate analysis for survival and treatment outcomes.

Conclusions: Submandibular gland carcinomas represent rare and heterogenous tumor group regarding histological appearance and locoregional and distant metastatic potential. Tumor histological grade, AJCC tumor stage and nodal status were the strongest predictive factors for survival and treatment outcomes. RT improved OS and locoregional treatment outcome, but not DFS. Elective neck dissection (END) could be beneficial for selected cases of SGC. Superselective neck dissection of levels I-IIa may be the level of dissection for END. Distant metastases were the main cause of death and treatment failure. Prognostic factors for poor DMFS were AJCC stage III and IV, high tumor grade and nodal status.

Keywords: Distant metastasis; Elective neck dissection; Nodal status; Submandibular salivary gland; Survival outcomes; Treatment outcomes; salivary gland carcinoma.

MeSH terms

Carcinoma, Adenoid Cystic* / diagnosis
Carcinoma, Adenoid Cystic* / therapy
Humans
Salivary Gland Neoplasms* / diagnosis
Salivary Gland Neoplasms* / therapy
Submandibular Gland / pathology
Treatment Failure
Treatment Outcome