Distant metastasis of salivary gland cancer: Incidence, management, and outcomes
Background Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment. Methods Patients with DMs were identified from an institutional database of 884 patients with salivary gland cancer who underwent...
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Published in | Cancer Vol. 126; no. 10; pp. 2153 - 2162 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Wiley Subscription Services, Inc
15.05.2020
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Abstract | Background
Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment.
Methods
Patients with DMs were identified from an institutional database of 884 patients with salivary gland cancer who underwent resection of the primary tumor between 1985 and 2015. Survival outcomes for patients with DMs were determined with the Kaplan‐Meier method. Univariate and multivariate analyses were performed to identify factors associated with DM.
Results
Of the 884 patients identified, 137 (15%) developed DMs during follow‐up. Most of the primary tumors (n = 77 [56%]) were located in a major salivary gland. At clinical presentation, 53% of the tumors were classified as T3 or T4, and 32% had clinical node metastases. The median time to DM was 20.3 months. The factors associated with shorter distant recurrence–free survival were male sex, high‐risk tumor histology, and advanced pathological T and N classifications. Patients with bone metastases had a lower survival rate than patients with lung metastases. The total number of DMs in a patient was inversely associated with survival. Patients who underwent surgical resection of DMs had a significantly higher 5‐year rate of metastatic disease–specific survival than patients who underwent observation or nonsurgical treatment (44%, 29%, and 19%, respectively; P = .003).
Conclusions
In patients with DMs of salivary gland carcinoma, survival is negatively associated with high‐grade histology, bone DMs, and the total number of DMs. Metastasectomy can help to lengthen disease‐free survival.
Outcomes for metastatic salivary gland tumors are driven by the pathology, site, and number of distant metastases. Metastasectomy offers the benefit of long disease‐free survival for select patients. |
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AbstractList | Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment.
Patients with DMs were identified from an institutional database of 884 patients with salivary gland cancer who underwent resection of the primary tumor between 1985 and 2015. Survival outcomes for patients with DMs were determined with the Kaplan-Meier method. Univariate and multivariate analyses were performed to identify factors associated with DM.
Of the 884 patients identified, 137 (15%) developed DMs during follow-up. Most of the primary tumors (n = 77 [56%]) were located in a major salivary gland. At clinical presentation, 53% of the tumors were classified as T3 or T4, and 32% had clinical node metastases. The median time to DM was 20.3 months. The factors associated with shorter distant recurrence-free survival were male sex, high-risk tumor histology, and advanced pathological T and N classifications. Patients with bone metastases had a lower survival rate than patients with lung metastases. The total number of DMs in a patient was inversely associated with survival. Patients who underwent surgical resection of DMs had a significantly higher 5-year rate of metastatic disease-specific survival than patients who underwent observation or nonsurgical treatment (44%, 29%, and 19%, respectively; P = .003).
In patients with DMs of salivary gland carcinoma, survival is negatively associated with high-grade histology, bone DMs, and the total number of DMs. Metastasectomy can help to lengthen disease-free survival. Background Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment. Methods Patients with DMs were identified from an institutional database of 884 patients with salivary gland cancer who underwent resection of the primary tumor between 1985 and 2015. Survival outcomes for patients with DMs were determined with the Kaplan‐Meier method. Univariate and multivariate analyses were performed to identify factors associated with DM. Results Of the 884 patients identified, 137 (15%) developed DMs during follow‐up. Most of the primary tumors (n = 77 [56%]) were located in a major salivary gland. At clinical presentation, 53% of the tumors were classified as T3 or T4, and 32% had clinical node metastases. The median time to DM was 20.3 months. The factors associated with shorter distant recurrence–free survival were male sex, high‐risk tumor histology, and advanced pathological T and N classifications. Patients with bone metastases had a lower survival rate than patients with lung metastases. The total number of DMs in a patient was inversely associated with survival. Patients who underwent surgical resection of DMs had a significantly higher 5‐year rate of metastatic disease–specific survival than patients who underwent observation or nonsurgical treatment (44%, 29%, and 19%, respectively; P = .003). Conclusions In patients with DMs of salivary gland carcinoma, survival is negatively associated with high‐grade histology, bone DMs, and the total number of DMs. Metastasectomy can help to lengthen disease‐free survival. Outcomes for metastatic salivary gland tumors are driven by the pathology, site, and number of distant metastases. Metastasectomy offers the benefit of long disease‐free survival for select patients. BACKGROUNDDistant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment. METHODSPatients with DMs were identified from an institutional database of 884 patients with salivary gland cancer who underwent resection of the primary tumor between 1985 and 2015. Survival outcomes for patients with DMs were determined with the Kaplan-Meier method. Univariate and multivariate analyses were performed to identify factors associated with DM. RESULTSOf the 884 patients identified, 137 (15%) developed DMs during follow-up. Most of the primary tumors (n = 77 [56%]) were located in a major salivary gland. At clinical presentation, 53% of the tumors were classified as T3 or T4, and 32% had clinical node metastases. The median time to DM was 20.3 months. The factors associated with shorter distant recurrence-free survival were male sex, high-risk tumor histology, and advanced pathological T and N classifications. Patients with bone metastases had a lower survival rate than patients with lung metastases. The total number of DMs in a patient was inversely associated with survival. Patients who underwent surgical resection of DMs had a significantly higher 5-year rate of metastatic disease-specific survival than patients who underwent observation or nonsurgical treatment (44%, 29%, and 19%, respectively; P = .003). CONCLUSIONSIn patients with DMs of salivary gland carcinoma, survival is negatively associated with high-grade histology, bone DMs, and the total number of DMs. Metastasectomy can help to lengthen disease-free survival. Outcomes for metastatic salivary gland tumors are driven by the pathology, site, and number of distant metastases. Metastasectomy offers the benefit of long disease‐free survival for select patients. Outcomes in metastatic salivary gland tumors are driven by pathology, site and number of distant metastases. Metastasectomy offers the benefit of a long disease-free survival in selected patients. |
Author | Karassawa Zanoni, Daniella Hay, Ashley Shah, Jatin P. Wong, Richard J. Ganly, Ian McGill, Marlena Ho, Alan Cohen, Marc A. Mimica, Ximena Patel, Snehal G. |
AuthorAffiliation | 2 Head and Neck Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 1 Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY |
AuthorAffiliation_xml | – name: 1 Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY – name: 2 Head and Neck Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32097509$$D View this record in MEDLINE/PubMed |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 AUTHOR CONTRIBUTIONS Ximena Mimica: Concept; acquisition and performance of the analysis; drafting of the manuscript, tables, and figures; responsibility for the overall content; and review of the final document and approval for publication. Marlena McGill: Substantial contributions to the acquisition and performance of the analysis; review of the final document and approval for publication. Ashley Hay: Substantial contributions to the acquisition and performance of the analysis and review of the final document and approval for publication. Daniella Karassawa Zanoni: Substantial contributions to the acquisition and performance of the analysis and review of the final document and approval for publication. Jatin P. Shah: Concept and review of the final document and approval for publication. Richard J. Wong: Concept and review of the final document and approval for publication. Alan Ho: Concept and review of the final document and approval for publication. Marc A. Cohen: Concept and review of the final document and approval for publication. Snehal Patel: Concept and review of the final document and approval for publication. Ian Ganly: Concept; drafting of the manuscript, tables, and figures; responsibility for the overall content; and review of the final document and approval for publication. |
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Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard... Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment.... Outcomes for metastatic salivary gland tumors are driven by the pathology, site, and number of distant metastases. Metastasectomy offers the benefit of long... BackgroundDistant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard... BACKGROUNDDistant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard... Outcomes in metastatic salivary gland tumors are driven by pathology, site and number of distant metastases. Metastasectomy offers the benefit of a long... |
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SubjectTerms | Adolescent Adult Aged Aged, 80 and over Cancer Female Health services Histology Humans Incidence Male Metastases Metastasis Middle Aged Neoplasm Metastasis - diagnosis Neoplasm Metastasis - pathology Neoplasm Staging Oncology Oral cancer Patients Risk Factors Salivary gland salivary gland cancer Salivary Gland Neoplasms - mortality Salivary Gland Neoplasms - pathology Salivary Gland Neoplasms - surgery Salivary glands Sex Characteristics surgery Survival Survival Analysis Tumors Young Adult |
Title | Distant metastasis of salivary gland cancer: Incidence, management, and outcomes |
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