Contemporary treatment patterns and outcomes of salivary gland carcinoma: a National Cancer Database review

Jay K. Ferrell, Jess C. Mace, Daniel Clayburgh

Research output: Contribution to journalArticle

Abstract

Purpose: Salivary gland carcinomas (SGC) are rare malignancies and data regarding treatment outcomes stratified by histologic subtype are currently limited. This study aims to examine current, national treatment patterns and overall survival (OS) of patients with the major histologic subtypes of salivary gland carcinoma. Subjects and methods: A review was performed of the National Cancer Database (NCDB) of patients with confirmed diagnoses of mucoepidermoid carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma, or carcinoma ex pleomorphic receiving curative treatment between 2004 and 2014. Univariate and multivariate regression modeling were performed to identify risk factors significantly associated with overall survival (OS). Adjusted survival analyses stratified by treatment and staging were performed with the primary outcome of overall survival (OS) and were further stratified based on histologic subtype. Results: The final analysis included 7342 patients [3547 men (48.3%) and 3795 women (51.7%); mean age 58.3 years (range 18–90 years)]. Mucoepidermoid carcinoma was the most common histology encountered [n = 2669 (36.4%)]. Unadjusted and adjusted analysis demonstrated improved survival with surgery and radiation therapy (RT) for adenoid cystic (HR = 0.69; p = 0.029), adenocarcinoma (HR = 0.61; p < 0.001), high-grade mucoepidermoid carcinoma (HR = 0.70; p = 0.026), and carcinoma ex pleomorphic (HR = 0.64; p = 0.028), while surgery with chemoradiation therapy (CRT) was associated with worse OS regardless of histologic subtype. The impact of advanced stage on survival varied amongst the histologic subtypes but portended the worst prognosis for patients with adenocarcinoma and carcinoma ex pleomorphic. Conclusions: The results of this NCDB review demonstrate unique treatment patterns and survival outcomes for SGC based on major histologic subtype.

Original languageEnglish (US)
JournalEuropean Archives of Oto-Rhino-Laryngology
DOIs
StateAccepted/In press - Jan 1 2019

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Salivary Glands
Databases
Carcinoma
Survival
Mucoepidermoid Carcinoma
Neoplasms
Adenocarcinoma
Acinar Cell Carcinoma
Therapeutics
Adenoids
Adenoid Cystic Carcinoma
Survival Analysis
Histology
Radiotherapy

Keywords

  • Cancer of salivary gland
  • Head and neck cancer
  • National Cancer Database
  • Salivary gland
  • Treatment outcomes

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

@article{9ba5e0e877c34b18994bd0d762d5cd55,
title = "Contemporary treatment patterns and outcomes of salivary gland carcinoma: a National Cancer Database review",
abstract = "Purpose: Salivary gland carcinomas (SGC) are rare malignancies and data regarding treatment outcomes stratified by histologic subtype are currently limited. This study aims to examine current, national treatment patterns and overall survival (OS) of patients with the major histologic subtypes of salivary gland carcinoma. Subjects and methods: A review was performed of the National Cancer Database (NCDB) of patients with confirmed diagnoses of mucoepidermoid carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma, or carcinoma ex pleomorphic receiving curative treatment between 2004 and 2014. Univariate and multivariate regression modeling were performed to identify risk factors significantly associated with overall survival (OS). Adjusted survival analyses stratified by treatment and staging were performed with the primary outcome of overall survival (OS) and were further stratified based on histologic subtype. Results: The final analysis included 7342 patients [3547 men (48.3{\%}) and 3795 women (51.7{\%}); mean age 58.3 years (range 18–90 years)]. Mucoepidermoid carcinoma was the most common histology encountered [n = 2669 (36.4{\%})]. Unadjusted and adjusted analysis demonstrated improved survival with surgery and radiation therapy (RT) for adenoid cystic (HR = 0.69; p = 0.029), adenocarcinoma (HR = 0.61; p < 0.001), high-grade mucoepidermoid carcinoma (HR = 0.70; p = 0.026), and carcinoma ex pleomorphic (HR = 0.64; p = 0.028), while surgery with chemoradiation therapy (CRT) was associated with worse OS regardless of histologic subtype. The impact of advanced stage on survival varied amongst the histologic subtypes but portended the worst prognosis for patients with adenocarcinoma and carcinoma ex pleomorphic. Conclusions: The results of this NCDB review demonstrate unique treatment patterns and survival outcomes for SGC based on major histologic subtype.",
keywords = "Cancer of salivary gland, Head and neck cancer, National Cancer Database, Salivary gland, Treatment outcomes",
author = "Ferrell, {Jay K.} and Mace, {Jess C.} and Daniel Clayburgh",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00405-019-05282-2",
language = "English (US)",
journal = "Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde",
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T1 - Contemporary treatment patterns and outcomes of salivary gland carcinoma

T2 - a National Cancer Database review

AU - Ferrell, Jay K.

AU - Mace, Jess C.

AU - Clayburgh, Daniel

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Salivary gland carcinomas (SGC) are rare malignancies and data regarding treatment outcomes stratified by histologic subtype are currently limited. This study aims to examine current, national treatment patterns and overall survival (OS) of patients with the major histologic subtypes of salivary gland carcinoma. Subjects and methods: A review was performed of the National Cancer Database (NCDB) of patients with confirmed diagnoses of mucoepidermoid carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma, or carcinoma ex pleomorphic receiving curative treatment between 2004 and 2014. Univariate and multivariate regression modeling were performed to identify risk factors significantly associated with overall survival (OS). Adjusted survival analyses stratified by treatment and staging were performed with the primary outcome of overall survival (OS) and were further stratified based on histologic subtype. Results: The final analysis included 7342 patients [3547 men (48.3%) and 3795 women (51.7%); mean age 58.3 years (range 18–90 years)]. Mucoepidermoid carcinoma was the most common histology encountered [n = 2669 (36.4%)]. Unadjusted and adjusted analysis demonstrated improved survival with surgery and radiation therapy (RT) for adenoid cystic (HR = 0.69; p = 0.029), adenocarcinoma (HR = 0.61; p < 0.001), high-grade mucoepidermoid carcinoma (HR = 0.70; p = 0.026), and carcinoma ex pleomorphic (HR = 0.64; p = 0.028), while surgery with chemoradiation therapy (CRT) was associated with worse OS regardless of histologic subtype. The impact of advanced stage on survival varied amongst the histologic subtypes but portended the worst prognosis for patients with adenocarcinoma and carcinoma ex pleomorphic. Conclusions: The results of this NCDB review demonstrate unique treatment patterns and survival outcomes for SGC based on major histologic subtype.

AB - Purpose: Salivary gland carcinomas (SGC) are rare malignancies and data regarding treatment outcomes stratified by histologic subtype are currently limited. This study aims to examine current, national treatment patterns and overall survival (OS) of patients with the major histologic subtypes of salivary gland carcinoma. Subjects and methods: A review was performed of the National Cancer Database (NCDB) of patients with confirmed diagnoses of mucoepidermoid carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma, or carcinoma ex pleomorphic receiving curative treatment between 2004 and 2014. Univariate and multivariate regression modeling were performed to identify risk factors significantly associated with overall survival (OS). Adjusted survival analyses stratified by treatment and staging were performed with the primary outcome of overall survival (OS) and were further stratified based on histologic subtype. Results: The final analysis included 7342 patients [3547 men (48.3%) and 3795 women (51.7%); mean age 58.3 years (range 18–90 years)]. Mucoepidermoid carcinoma was the most common histology encountered [n = 2669 (36.4%)]. Unadjusted and adjusted analysis demonstrated improved survival with surgery and radiation therapy (RT) for adenoid cystic (HR = 0.69; p = 0.029), adenocarcinoma (HR = 0.61; p < 0.001), high-grade mucoepidermoid carcinoma (HR = 0.70; p = 0.026), and carcinoma ex pleomorphic (HR = 0.64; p = 0.028), while surgery with chemoradiation therapy (CRT) was associated with worse OS regardless of histologic subtype. The impact of advanced stage on survival varied amongst the histologic subtypes but portended the worst prognosis for patients with adenocarcinoma and carcinoma ex pleomorphic. Conclusions: The results of this NCDB review demonstrate unique treatment patterns and survival outcomes for SGC based on major histologic subtype.

KW - Cancer of salivary gland

KW - Head and neck cancer

KW - National Cancer Database

KW - Salivary gland

KW - Treatment outcomes

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