Survival Impact of Adjuvant Therapy in Salivary Gland Cancers following Resection and Neck Dissection

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http://hdl.handle.net/10138/318791

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Aro , K , Ho , A S , Luu , M , Kim , S , Tighiouart , M , Yoshida , E J , Mallen-St Clair , J , Shiao , S L , Leivo , I & Zumsteg , Z S 2019 , ' Survival Impact of Adjuvant Therapy in Salivary Gland Cancers following Resection and Neck Dissection ' , Otolaryngology - Head and Neck Surgery , vol. 160 , no. 6 , pp. 1048-1057 . https://doi.org/10.1177/0194599819827851

Title: Survival Impact of Adjuvant Therapy in Salivary Gland Cancers following Resection and Neck Dissection
Author: 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.
Contributor: University of Helsinki, HUS Head and Neck Center
Date: 2019-06
Language: eng
Number of pages: 10
Belongs to series: Otolaryngology - Head and Neck Surgery
ISSN: 0194-5998
URI: http://hdl.handle.net/10138/318791
Abstract: 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.
Subject: salivary gland cancer
metastasis
radiotherapy
survival
POSTOPERATIVE RADIATION-THERAPY
MALIGNANT-TUMORS
RADIOTHERAPY
CARCINOMA
SURGERY
HEAD
CHEMORADIOTHERAPY
CHEMOTHERAPY
IRRADIATION
IMPUTATION
3125 Otorhinolaryngology, ophthalmology
3126 Surgery, anesthesiology, intensive care, radiology
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