Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_34_2803 - Outcomes and Prognostic Factors for Major Salivary Gland Carcinoma Treated with Surgery and Postoperative Radiation Therapy

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Outcomes and Prognostic Factors for Major Salivary Gland Carcinoma Treated with Surgery and Postoperative Radiation Therapy
C. Shen, X. Zhou, X. LU, and C. Hu; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China

Purpose/Objective(s): Major salivary gland (MSG) cancers are uncommon among the head and neck regions, and there is a dearth of prospective reports on this entity. The purpose of this retrospective study is to present the clinical outcomes for patients diagnosed with MSG carcinoma and to identify the individuals at high risk of failures.

Materials/Methods: We reviewed 249 cases of MSG carcinoma treated with surgery and postoperative radiotherapy (PORT) at our institution between 2006 and 2014. Outcomes were documented with follow-up until December 2017. The endpoints were local control (LC) regional control (RC), distant metastases (DM), overall survival (OS) and progression free survival (PFS). Time to events was calculated from the date of initial surgical resection.

Results: The main three histological types were lymphoepithelial, adenoid cystic and mucoepidermoid carcinoma. Perineural invasion was observed in 44 patients. According to the 7th edition of AJCC Staging system, 54% of patients were staged to I-II while 46% were to III-IV. Median follow-up was 63.6 months and 76.3% malignancies were originated from parotid glands. Median dose of PORT was 60Gy delivered using 3D-CRT or IMRT. The most frequent failure in our series was DM (n=47). The 5-year Kaplan-Meier estimates for LC, RC, DM, OS and PFS were 95.6%, 95.7%, 18.4%, 83.6% and 75.4%, respectively. The 5-year OS was 94.3% for stage I-II compared to 69.7% for stage III-IV (P<0.001). Multivariate analysis showed locally advanced TNM stage, high grade of histopathology and perineural invasion were the ominous prognostic factors for OS and PFS.

Conclusion: Surgery combined with PORT is an effective treatment strategy for MSG carcinoma and produced superior long-term outcomes. Patients with high risk factors such as advanced T or N stage, perineural invasion had a poor survival rates. In view of the pattern of failures observed, systemic treatment modalities liking chemotherapy or targeted therapy aiming to reduce DM should be investigated and strengthened in the future.

Author Disclosure: C. Shen: None. X. LU: None.

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