2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

Original Investigation Research

Survival in Carcinoma of the Minor Salivary Gland

One strength of the SEERdatabase is the large sample size, which provides sufficient power to examine rare malignant neoplasms such as MSG carcinoma and permit multivariable analyses. In addition, the population-based rather than insti- tution-based identification of patients in the SEER database lends external validity to SEER analyses. Institutional stud- ies are usually confined tomajor referral centers andmay not be representative of the patients with MSG cancers who are treated in community hospitals and clinics. Conclusions This study, to our knowledge, represents the largest US sur- vival analyses among patients with MSG carcinoma. Progno- sis is associatedwith histologic subtype, tumor subsite, age at diagnosis, tumor grade, and surgical therapy.

These data would be useful for determining candidacy for sur- gical intervention. The SEERdatabase also does not contain in- formation on important survival predictors that include health insurance,whichmaydetermineaccesstoanduseofhealthcare. Intermsofsurgicaltherapy,393patients(7.4%)weremissingdata on treatment type. These missing data may have affected the trendsweobserved insurgical treatment across the studyperiod and possibly the associated effect on survival. In addition, the SEERstagingsystemisnotasclinicallyapplicableastheaccepted AmericanJointCommitteeonCancer stagingsystemfor salivary glandmalignant neoplasms. Furthermore, the 1977 SEER stag- ing systemunderwent a revision in 2000, 24 which could allow fordifferencesinstageclassification,dependingontheyearacase was entered in the database. Finally, the differentiation-based grading systemlimitedour analysis toadenocarcinomaNOSbe- cause other types of adenocarcinoma,MEC, andACC cannot be graded accurately based on differentiation alone.

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6 . Spiro RH, Koss LG, Hajdu SI, Strong EW. Tumors of minor salivary origin: a clinicopathologic study of 492 cases. Cancer . 1973;31(1):117-129 . 7 . Spiro RH. Management of malignant tumors of the salivary glands. Oncology (Williston Park) . 1998; 12(5):671-680 . 8 . Spiro RH. Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg . 1986;8(3):177-184 . 9 . Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg . 1991;162 (4):330-336 . 10 . Chou C, Zhu G, Luo M, Xue G. Carcinoma of the minor salivary glands: results of surgery and combined therapy. J Oral Maxillofac Surg . 1996;54 (4):448-453 . 11 . Fu KK, Leibel SA, Levine ML, Friedlander LM, Boles R, Phillips TL. Carcinoma of the major and minor salivary glands: analysis of treatment results and sites and causes of failures. Cancer . 1977;40(6): 2882-2890 . 12 . Anderson JN Jr, Beenken SW, Crowe R, et al. Prognostic factors in minor salivary gland cancer. Head Neck . 1995;17(6):480-486 . 13 . Parsons JT, Mendenhall WM, Stringer SP, Cassisi NJ, Million RR. Management of minor salivary gland carcinomas. Int J Radiat Oncol Biol Phys . 1996;35(3):443-454 . 14 . Vander Poorten VLM, Balm AJM, Hilgers FJM, Tan IB, Keus RB, Hart AAM. Stage as major long term outcome predictor in minor salivary gland carcinoma. Cancer . 2000;89(6):1195-1204 . 15 . Kakarala K, Bhattacharyya N. Survival in oral cavity minor salivary gland carcinoma. Otolaryngol Head Neck Surg . 2010;143(1):122-126 . 16 . Loh KS, Barker E, Bruch G, et al. Prognostic factors in malignancy of the minor salivary glands. Head Neck . 2009;31(1):58-63 . 17 . Vander Poorten V, Hunt J, Bradley PJ, et al. Recent trends in the management of minor salivary gland carcinoma. Head Neck . 2014;36(3):444-455 . 18 . Copelli C, Bianchi B, Ferrari S, Ferri A, Sesenna E. Malignant tumors of intraoral minor salivary glands. Oral Oncol . 2008;44(7):658-663 .

ARTICLE INFORMATION Submitted for Publication: June 2, 2015; final revision received September 28, 2015; accepted October 2, 2015. Published Online: December 3, 2015. doi: 10.1001/jamaoto.2015.2805 . Author Contributions: Ms Fedewa and Dr Chen had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: All authors. Acquisition, analysis, or interpretation of data: Baddour, Fedewa. Drafting of the manuscript: Baddour, Fedewa. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Fedewa. Study supervision: Chen. Conflict of Interest Disclosures: None reported. Previous Presentation: This paper was presented at the Fifth World Congress of the International Federation of Head and Neck Oncologic Societies and Annual Meeting of the American Head and Neck Society; July 27, 2014; New York, New York. REFERENCES 1 . Ord RA, Pazoki AE. Salivary gland disease and tumors. In: Miloro M, Ghali GC, Larsen PE, Waite PD, eds. Peterson’s Principles of Oral and Maxillofacial Surgery. 2nd ed. Hamilton, ON: BC Decker Inc; 2004:671-677. 2 . Toida M, Shimokawa K, Makita H, et al. Intraoral minor salivary gland tumors: a clinicopathological study of 82 cases. Int J Oral Maxillofac Surg . 2005; 34(5):528-532 . 3 . Strick MJ, Kelly C, Soames JV, McLean NR. Malignant tumours of the minor salivary glands: a 20 year review. Br J Plast Surg . 2004;57(7): 624-631 . 4 . Jansisyanont P, Blanchaert RH Jr, Ord RA. Intraoral minor salivary gland neoplasm: a single institution experience of 80 cases. Int J Oral Maxillofac Surg . 2002;31(3):257-261 . 5 . Ellis GL, Auclair PL. The normal salivary glands. In: Ellis GL, Auclair PL, eds. Tumors of the Salivary Glands. 3rd series. Washington, DC: Armed Forces Institute of Pathology; 1996:1-23.

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