Helda

Helsingin yliopisto

Helsingfors universitet

University of Helsinki

Browsing by Subject "MALIGNANT-TUMORS"

Now showing items 1-2 of 2

Polymorphous adenocarcinoma of the salivary glands : reappraisal and update

Vander Poorten, Vincent; Triantafyllou, Asterios; Skalova, Alena; Stenman, Göran; Bishop, Justin A.; Hauben, Esther; Hunt, Jennifer L.; Hellquist, Henrik; Feys, Simon; De Bree, Remco; Mäkitie, Antti A.; Quer, Miquel; Strojan, Primoz; Guntinas-Lichius, Orlando; Rinaldo, Alessandra; Ferlito, Alfio (2018)

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.
Survival Impact of Adjuvant Therapy in Salivary Gland Cancers following Resection and Neck Dissection

Aro, Katri; Ho, Allen S.; Luu, Michael; Kim, Sungjin; Tighiouart, Mourad; Yoshida, Emi J.; Mallen-St Clair, Jon; Shiao, Stephen L.; Leivo, Ilmo; Zumsteg, Zachary S. (2019)

Objective To evaluate the impact of postoperative radiotherapy (PORT) and chemotherapy on survival in salivary gland cancer (SGC) treated with curative-intent local resection and neck dissection. Study Design Retrospective population-based cohort study. Setting National Cancer Database. Subjects and Methods Patients with SGC who were undergoing surgery were identified from the National Cancer Database between 2004 and 2013. Neck dissection removing a minimum of 10 lymph nodes was required. Because PORT violated the proportional hazards assumption, this variable was treated as a time-dependent covariate. Results Overall, 4145 cases met inclusion criteria (median follow-up, 54 months). PORT was associated with improved overall survival in multivariable analysis, both 9 months (HR, 0.75; 95% CI, 0.66-0.86; P <.001). In propensity score-matched cohorts, 5-year overall survival was 67.1% and 60.6% with PORT and observation, respectively (P <.001). Similar results were observed in landmark analysis of patients surviving at least 6 months following diagnosis. Adjuvant chemotherapy was not associated with improved survival (HR, 1.15; 95% CI, 0.99-1.34; P = .06). Conclusion PORT, but not chemotherapy, is associated with improved survival among patients with SGC for whom neck dissection was deemed necessary. These results are not applicable to low-risk SGCs not requiring neck dissection.