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Published in: Annals of Surgical Oncology 13/2016

01-12-2016 | Head and Neck Oncology

Low-Grade Salivary Gland Cancers: Treatment Outcomes, Extent of Surgery and Indications for Postoperative Adjuvant Radiation Therapy

Authors: Jae-Keun Cho, MD, Byung-Woo Lim, MD, Eun-Hye Kim, RN, Young-Hyeh Ko, MD, PhD, Dongryul Oh, MD, Jae-Myoung Noh, MD, Yong Chan Ahn, MD, PhD, Kwan-Hyuck Baek, PhD, Han-Sin Jeong, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2016

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Abstract

Background

Histologic grade of tumor is one of the major prognostic predictors for patients with salivary gland cancer. Because of disease rarity, little is known about the optimal treatment modalities and outcomes in low-grade salivary gland cancers (LGSGC). We tried to identify prognostic factors, and the adequate treatment modalities and outcomes in pathologically confirmed LGSGC patients.

Methods

We retrospectively extracted the clinical and pathology data from 179 LGSGC cases from 1995 to 2013. Pathological features, such as extraparenchymal extension, perineural/nerve invasion, lymphovascular invasion/tumor emboli, and resection margin status were redefined for each case. Risk factors for recurrence, extent of surgery, and the role of postoperative radiation therapy were analyzed.

Results

Recurrence-free survival and overall survival were 89.6 and 96.6 % at 10 years, respectively. The presence of regional nodal metastasis and positive cancer cells at resection margin were significant unfavorable prognostic factors. Postoperative adjuvant radiation treatment significantly reduced recurrences, particularly in cases with pathology risk factors (perineural invasion, lymphovascular invasion, extraparenchymal extension, or cancer cells at the resection margin), node metastasis, and advanced T-stage tumors. Close surgical margin <5 mm was not a significant risk factor for recurrence, and less-than-total resection of the affected gland did not increase recurrence, if surgery could achieve a cancer cell-free surgical margin.

Conclusion

Postoperative radiation clearly benefitted patients with pathology risk factors, node metastasis, and advanced T stage in LGSGC. Meanwhile, the oncological outcomes are very good with surgery alone in cases of pT1-2N0 LGSGC without pathology risk factors.
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Metadata
Title
Low-Grade Salivary Gland Cancers: Treatment Outcomes, Extent of Surgery and Indications for Postoperative Adjuvant Radiation Therapy
Authors
Jae-Keun Cho, MD
Byung-Woo Lim, MD
Eun-Hye Kim, RN
Young-Hyeh Ko, MD, PhD
Dongryul Oh, MD
Jae-Myoung Noh, MD
Yong Chan Ahn, MD, PhD
Kwan-Hyuck Baek, PhD
Han-Sin Jeong, MD, PhD
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5353-6

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