geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

A 20-Year Review of 75 Cases of Salivary Duct Carcinoma


, : A 20-Year Review of 75 Cases of Salivary Duct Carcinoma. JAMA Otolaryngology-- Head & Neck Surgery 142(5): 489-495

Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. To review the University of Pittsburgh Medical Center's experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution's Head and Neck Oncology Database for further clinical details. Primary outcome measures consisted of OS and DFS. The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33-93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4.5 years, respectively). Although underpowered, multivariable analysis demonstrated significantly worse OS in patients with N2 and N3 disease (hazard ratio [HR] 8.42, 95% CI, 1.84-38.5) but did not show significantly worse DFS or OS for facial nerve sacrifice or extracapsular spread. There was no association between ERBB2 positivity and survival and no difference in survival between patients receiving radiation therapy vs radiation therapy plus chemotherapy. No patients had recurrence or distant metastasis after 5 disease-free years. Salivary duct carcinoma is an aggressive disease. A large number of cases in this review were carcinoma ex pleomorphic adenoma and had classic negative prognostic indicators, such as perineural invasion, vascular invasion, and extracapsular spread. ERBB2 positivity was not associated with any difference in survival. Facial nerve involvement appears to indicate worse prognosis, as does nodal stage higher than N1. Recurrence and metastasis after 5 years are rare.

US$19.90

PMID: 26939990

DOI: 10.1001/jamaoto.2015.3930


Other references

Tillyard, R.J., 1907: Petalura ingentissima n sp. Zoologischer Anzeiger Leipzig, 32 431-432

Bodelsson, G.; Stjernquist, M., 1994: Endothelium-dependent relaxation to substance P in human umbilical artery is mediated via prostanoid synthesis. To investigate the relaxatory effect and mode of action of substance P in the human umbilical artery, ring segments of the artery were suspended in organ baths to record the circular motor activity. Substance P induced a significant relaxation in...

Sulkowski, M.S., 2005: Management of the hematologic complications of hepatitis C therapy. Consensus guidelines are in place for treating chronic hepatitis C virus infection. This article highlights some of the hematologic complications of hepatitis C therapy. Management options are presented.

Goulet, J.P.; Morency, R.; Pérusse, R.; Maurais, M., 1987: Osteoradionecrosis: risks and prevention in dentistry. Le Journal Dentaire du Quebec 24: 259-265

Sullivan, M.J.; Alpert, S.; Martin, G.J., 1953: The effect of the phosphonic cation exchange resin on mineral balance in the rat. Journal of the American Pharmaceutical Association. American Pharmaceutical Association 42(6): 357-360

Park, J.Phil.; Bahn, C.Bum., 2016: Uncertainty Evaluation of Weibull Estimators through Monte Carlo Simulation: Applications for Crack Initiation Testing. The typical experimental procedure for testing stress corrosion cracking initiation involves an interval-censored reliability test. Based on these test results, the parameters of a Weibull distribution, which is a widely accepted crack initiation...

Byrne, E.; Trounce, I., 1985: Oxygen electrode studies with human skeletal muscle mitochondria in vitro. A re-appraisal. Polarographic measurement of respiration rates in skeletal muscle mitochondria is a valuable research tool in human disease but the data on normal muscle are sparse and conflicting. In this study, mitochondria were isolated from 18 normal muscle b...

Sundberg, F., A.; Kurkewicz, R.; Rooks, D., L., 2007: Wujiajiania sutherlandi fauna (Elvinia biozone, paibian stage, furongian series - Upper cambrian) from the emigrant formation, Nevada. Journal of Paleontology 81(4): 794-796

Jackson, R.P.; Simmons, E.H.; Stripinis, D., 1989: Coronal and sagittal plane spinal deformities correlating with back pain and pulmonary function in adult idiopathic scoliosis. One hundred one referred adult patients (ages 20-63; mean, 36 years) with painful idiopathic scoliosis were evaluated. None had prior surgical treatment. Severity of pain was graded and localized over radiographic deformities in the coronal and sa...

Pinto, M.; Solevåg, A.Lee.; OʼReilly, M.; Aziz, K.; Cheung, P-Yin.; Schmölzer, G.M., 2016: Evidence on Adrenaline Use in Resuscitation and Its Relevance to Newborn Infants: A Non-Systematic Review. Guidelines for newborn resuscitation state that if the heart rate does not increase despite adequate ventilation and chest compressions, adrenaline administration should be considered. However, controversy exists around the safety and effectivenes...