Clinical Outcome and Prognostic Factors in Patients with Malign Minor
and Major Salivary Gland Tumors of Head and Neck
Abstract
Purpose: This study evaluated the outcome of prognostic features
and survival results of the major and minor malignant salivary gland
carcinoma (MSGC) histopathologies. Materials and Methods: One
hundred-forty patients with major/minor MSGC were registered in
databases from 2004 to 2019. The median age of the patients was 57
(18-89). Major MSGC was diagnosed in 81 patients and mostly in the
parotid gland (49%). Minor MSGC was diagnosed in 59 patients and often
on the hard palate (19%). The most common histopathology is
mucoepidermoid carcinoma (MEC)(47%) in major MSGC and adenoid cystic
carcinoma (ACC) in minör MSGC (31%). Major MSGC was most diagnosed in
the early stages, while the minor MSGC was diagnosed in the advanced
stages. Results: Median follow-up is 73 months (5-197). The ten
year local control (LC) and the distant metastasis free survival (DMFS)
rates were 85% and 76%, respectively. The overall survival rate was
79% (10 years). The local control rates were statistically different in
the patients with R1-R2 diseases (p=0.039) and advanced T and N stages
(p=0.05, p=0.022, respectively). The presence of microscopic perineural
invasion (PNI) was not significant in local recurrence in patients with
ACC. Distant metastasis rates were statistically increased in patients
with advanced tumor and nodal stages (p=0.031, p=0.003, respectively),
R1-R2 disease (p=0.027), high grade (p=0.048), PNI (p=0.006).
Conclusions: Advanced tumor and nodal stage, high tumor grade,
and surgical margin status are strongly correlated with the worse
oncological outcomes. The prognostic significance of microscopic PNI has
not yet been clarified.