Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients

Kuninori Otsuka, Yorihisa Imanishi, Yuichiro Tada, Daisuke Kawakita, Satoshi Kano, Kiyoaki Tsukahara, Akira Shimizu, Hiroyuki Ozawa, Kenji Okami, Akihiro Sakai, Yuichiro Sato, Yushi Ueki, Yukiko Sato, Toyoyuki Hanazawa, Hideaki Chazono, Kaoru Ogawa, Toshitaka Nagao

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44 Citations (Scopus)

Abstract

Background: Among salivary gland malignancies, the prognosis of salivary duct carcinoma (SDC) is assumed to be the poorest. However, because of its low incidence, reliable survival estimates and prognostic factors based on a large number of patients remain to be elucidated, thereby making it impossible to standardize the optimal treatment for SDC. Methods: We performed this multi-institutional, retrospective analysis by collecting the clinical information of 141 patients with SDC without distant metastasis who underwent curative surgery as the initial treatment to elucidate overall survival (OS) and disease-free survival (DFS) along with their prognostic factors. Results: The 3-year OS and DFS rates were 70.5 and 38.2 %, respectively. Multivariate analysis revealed that age ≥65 years (p < 0.001) and N1 and N2 (p = 0.047 and <0.001, respectively) were independent prognostic factors for OS, whereas the primary site of the minor salivary and sublingual gland (p < 0.001) and N2 (p < 0.001) were those for DFS. The most common treatment failure was distant metastasis (55 patients, 39.0 %). For early parotid SDC, neither total parotidectomy in the patients with early T stage nor nerve resection in the patients without facial nerve palsy showed survival benefits. Conclusions: Advanced N stage independently affects both OS and DFS. Partial parotidectomy with facial nerve preservation could be a less invasive standard surgical procedure for parotid gland SDC in the early T stage without facial nerve palsy. Effective systemic therapy is imperative to improve DFS of SDC.

Original languageEnglish
Pages (from-to)2038-2045
Number of pages8
JournalAnnals of Surgical Oncology
Volume23
Issue number6
DOIs
Publication statusPublished - 2016 Jun 1

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Otsuka, K., Imanishi, Y., Tada, Y., Kawakita, D., Kano, S., Tsukahara, K., Shimizu, A., Ozawa, H., Okami, K., Sakai, A., Sato, Y., Ueki, Y., Sato, Y., Hanazawa, T., Chazono, H., Ogawa, K., & Nagao, T. (2016). Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients. Annals of Surgical Oncology, 23(6), 2038-2045. https://doi.org/10.1245/s10434-015-5082-2