Cervical lymph node metastatic status and adjuvant therapy predict the prognosis of salivary duct carcinoma

Publication date: Available online 19 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Kai Qian, Lu Di, Kai Guo, Xiaoke Zheng, Qinghai Ji, Zhuoying Wang
PurposeSalivary duct carcinoma (SDC) is an aggressive malignancy and is not yet fully understood. We designed this retrospective study to investigate the factors affecting the prognosis of salivary duct carcinoma and the effects of adjuvant therapies on clinical outcomes in patients.Materials and methodsPatients with major salivary gland duct carcinoma treated surgically between 2006 and 2016 were enrolled in the retrospective cohort study. Demographic data, clinical pathological characteristics and follow-up results were obtained. The prognostic indicators of overall survival (OS), locoregional failure-free survival (LRFFS) and distant metastasis-free survival (DMFS) were analyzed using the Kaplan–Meier method and the Cox Proportional Hazard Model.ResultsThe study sample comprised 66 patients, the majority of whom were male (81.8%). The 5-year OS, LRFFS and DMFS for all patients were 52.5, 63.9, and 51.3%, respectively. Univariate analysis showed that stages N2-3, lymph node involvement levels IV and V, ≥8 positive lymph nodes and extranodal extension were all negative prognostic indicators for OS. The only significant indicator in the multivariate analysis was the number of positive lymph nodes. Multivariate analysis revealed that extracapsular invasion and no adjuvant radiotherapy were risk factors for LRFFS, whereas lesions involving both glands and ≥8 positive lymph nodes were prognostic factors for DMFS. Further subgroup analysis showed that radiotherapy was only useful for patients with locally advanced lesions under local control.ConclusionCervical lymph node metastatic status is an important factor in predicting the prognosis of SDC patients. Adjuvant radiotherapy is useful for local control, especially for patients with stage T4 disease, but will not benefit OS and DMFS.



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