Surgery alone is effective in the management of pediatric salivary gland acinic cell carcinoma

Publication date: Available online 5 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Chong Wang, Minghui Mao, Bo Li, Kyojin Kim, Zhengxue Han, Zhien Feng

Abstract

Purpose

The treatment strategy of salivary gland acinic cell carcinoma in pediatric patients remains controversial. This retrospective study was undertaken to analyze the role of surgery in the treatment of acinic cell carcinoma of the major salivary gland in pediatric patients.

Methods

In this retrospective cohort study, we reviewed the medical records of all pediatric patients with acinic cell carcinoma of the major salivary gland who were treated at Beijing Stomatological Hospital of Capital Medical University from 1998 to 2015. The predictor variable was treatment modality. The outcome variables were disease-free survival (DFS), overall survival (OS), local control (LC) and freedom from distant metastasis (FFM). Other variables of interest were as follows: age, gender, tumor sites, T stage, N stage, recurrence history, pathological grade, perineural invasion (PNI), extracapsular extension (ECE), positive margin and resection conditions. The data analysis methods used were descriptive, bivariate statistics and the Cox proportional hazards regression model.

Results

Among the 19 patients, 7 received surgery alone, and 12 received initial surgery combined with postoperative radiotherapy (RT). During the median follow-up of 86 months, the overall estimates of DFS, OS, LC and FFM were 82.6, 93.3, 89.5, and 94.4%, respectively. Good outcomes were achieved in patients who received surgery alone (100% OS and 85.7% DFS). Initial surgery combined with postoperative RT was appropriate for patients with risk factors (91.7% OS and 83.3% DFS).

Conclusion

Surgery alone is appropriate for salivary gland acinic cell carcinoma in pediatric patients without risk factors, even if extracapsular excision is adopted. Preserving the invaded facial nerve during surgery is a good choice because a curative effect can be obtained when adjuvant RT is administered. Older age, high-grade pathology, incomplete resection, recurrence history and ECE were identified as risk factors of poor prognosis.

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