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

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Original Investigation Research

Epidemiology and Treatment of Malignant Submandibular Gland Tumors

Table 3. Multivariate Cox Regression Analysis for the Overall Population and Stratified by Stage at Presentation and Tumor Size

Overall Survival

Disease-Specific Survival

Characteristic

HR (95% CI)

P Value

HR (95% CI)

P Value

Overall Age

1.04 (1.03-1.04) 0.69 (0.57-0.84) 0.98 (0.86-1.12) 0.97 (0.94-1.00) 1.47 (1.19-1.81) 1.56 (1.41-1.72) 0.55 (0.41-0.74) 0.97 (0.79-1.19) 1.05 (1.04-1.07) 0.74 (0.50-1.10) 0.83 (0.62-1.11) 0.96 (0.90-1.03) 1.48 (0.98-2.25) 0.29 (0.10-0.86) 1.32 (0.86-2.04) 1.03 (1.02-1.04) 0.68 (0.54-0.85) 1.01 (0.87-1.17) 0.98 (0.95-1.01) 1.51 (1.18-1.92) 0.50 (0.37-0.67) 0.92 (0.72-1.16) 1.04 (1.03-1.05) 0.67 (0.50-0.90) 0.87 (0.71-1.06) 0.95 (0.91-1.00) 2.00 (1.46-2.73) 1.34 (1.19-1.51) 1.68 (0.53-5.39) 1.09 (0.80-1.49) 1.03 (1.02-1.04) 0.69 (0.51-0.93) 1.07 (0.89-1.29) 0.98 (0.94-1.03) 1.04 (0.77-1.43) 2.01 (1.62-2.50) 0.57 (0.39-0.83) 0.69 (0.51-0.95)

<.001 <.001

1.02 (1.01-1.03) 0.73 (0.56-0.96) 0.96 (0.82-1.13) 0.98 (0.94-1.02) 1.67 (1.25-2.25) 1.96 (1.69-2.28) 0.51 (0.35-0.75) 1.17 (0.85-1.60) 1.02 (1.00-1.04) 0.74 (0.38-1.45) 0.73 (0.43-1.22) 1.01 (0.89-1.13) 2.12 (1.03-4.35) 0.11 (0.01-0.94) 3.98 (1.53-10.40) 1.02 (1.01-1.03) 0.68 (0.51-0.92) 0.99 (0.83-1.18) 0.99 (0.95-1.03) 1.62 (1.18-2.24) 0.43 (0.29-0.63) 0.96 (0.69-1.34) 1.02 (1.00-1.03) 0.63 (0.41-0.98) 0.81 (0.59-1.10) 0.95 (0.89-1.02) 2.74 (1.69-4.45) 1.60 (1.33-1.94) 1.23 (0.29-5.21) 1.25 (0.74-2.12) 1.03 (1.01-1.04) 0.69 (0.47-1.03) 1.07 (0.87-1.33) 1.00 (0.95-1.06) 1.03 (0.69-1.53) 2.58 (1.88-3.53) 0.72 (0.43-1.19) 0.73 (0.47-1.14)

<.001

Sex

.02 .64 .30

Race

.78

Histologic subtype

.053

Grade

<.001 <.001 <.001

.001

Stage at presentation

<.001

Surgery

.001

Radiation therapy

.77

.34

Stage I, II Age

<.001

.052

Sex

.13 .20 .24 .06 .02 .21

.38 .22 .94 .04 .04

Race

Histologic subtype

Grade

Surgery

Radiation therapy

.005

Stage III, IV Age

<.001

Sex

.001

.01 .87 .62

Race

.92 .19

Histologic subtype

Grade

.001

.003

Surgery

<.001

Radiation Therapy

.47

.80

Size ≤3 cm Age

<.001

.03 .04 .17 .14

Sex

.007

Race

.16 .04

Histologic subtype

Grade

<.001 <.001

Stage at presentation

Surgery

.38 .60

.78 .40

Radiation therapy

Size >3 cm Age

<.001

Sex

.02 .50 .46 .79

.07 .52 .90 .91

Race

Histologic subtype

Grade

Stage at presentation

<.001

Surgery

.003

.20 .17

Radiation therapy

.02

Abbreviation: HR, hazard ratio.

on tumors of other major salivary gland tumors, leading to un- certaintyoftheprognosticfactorsandoptimaltreatmentforsub- mandibular glandmalignant neoplasms. 4,12,14,15,20,32 The SEER database allows for analysis of prognostic factors in survival with greater statistical power than previous studies. The SEER databasehas beenpreviouslyvalidated tohave the capability to find correlates of survival in many types of head and neck cancer. 25,33-36 However, fundamental limitations exist in such a studydesign. Thedatabase lacks informationonpatient comor-

Discussion Tumors presenting in the submandibular glandareuncommon, makinguponly5%to 15%of all salivaryglandneoplasms. 2-7 Be- causeof the relatively lowincidenceof thismalignantneoplasm, themajorityofstudiesonsubmandibularglandtumorshavebeen limitedtocasereportsandsmallsingle-ormulti-institutionstud- ies. In addition, they are often conductedwithin larger studies

(Reprinted) JAMA Otolaryngology–Head & Neck Surgery October 2015 Volume 141, Number 10

jamaotolaryngology.com

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