High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases

Freitag V, Lettmaier S, Semrau S, Hecht M, Mantsopoulos K, Müller-Hübner S, Traxdorf M, Iro H, Agaimy A, Fietkau R, Haderlein M (2021)

Publication Type: Journal article

Publication year: 2021

Journal

European Archives of Oto-Rhino-Laryngology Springer

DOI: 10.1007/s00405-021-07024-9

Abstract

Purpose: Salivary Gland cancer (SGC) is a rare and heterogenous group of tumors. Standard therapeutic options achieve high local but poor distant control rates, especially in high-grade SGC. The aim of this monocentric study was to evaluate patterns of recurrence and its treatment options (local ablative vs. systemic) in a homogenously treated patient population with high-grade SGC after surgery and radio(chemo)therapy. Methods: Monocentric, retrospective study of patients with newly diagnosed high-grade salivary gland cancer. We retrospectively reviewed clinical reports from 69 patients with high-grade salivary gland cancer in a single-center audit. Survival rates were calculated using the Kaplan–Meier method and prognostic variables were analyzed (univariate analysis: log-rank test; multivariate analysis: Cox regression analysis). Results: The median time of follow-up was 31 months. After 5 years, the cumulative overall survival was 65.2%, cumulative incidence of local recurrence was 7.2%, whereas the cumulative incidence of distant metastases was 43.5% after 5 years. 30 of 69 patients developed distant metastases during the time of follow-up, especially patients with adenoid cystic carcinoma, salivary duct carcinoma, adenocarcinoma NOS and acinic cell carcinoma with high-grade transformation. The most common type of therapy therefore was chemotherapy (50%). 85.7% of patients with local ablative therapy of distant metastases show disease progression during follow-up afterwards. Conclusion: With surgery and radio-chemotherapy, a high rate of loco-regional control is reached, but over 40% of patients develop distant metastases in the further follow-up which usually present a diffuse pattern involving in a diffuse metastases. Therefore, in the future, intensified interdisciplinary combination therapies even in the first-line treatment in certain subtypes of high-grade SGC should be investigated.

Authors with CRIS profile

Viola Freitag Medizinische Fakultät Sabine Semrau Lehrstuhl für Strahlentherapie Markus Hecht Department of Radiation Oncology Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Maximilian Traxdorf Medizinische Fakultät Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Rainer Fietkau Lehrstuhl für Strahlentherapie Marlen Haderlein Department of Radiation Oncology

How to cite

APA:

Freitag, V., Lettmaier, S., Semrau, S., Hecht, M., Mantsopoulos, K., Müller-Hübner, S.,... Haderlein, M. (2021). High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases. European Archives of Oto-Rhino-Laryngology. https://doi.org/10.1007/s00405-021-07024-9

MLA:

Freitag, Viola, et al. "High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases." European Archives of Oto-Rhino-Laryngology (2021).

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