Incompletely treated malignancies of the major salivary gland: Toward evidence-based care

Samantha Tam; Vlad C. Sandulache; Kareem A. Metwalli; Crosby D. Rock; Salman A. Eraj; Tommy Sheu; Adel K. El-Naggar; Clifton D. Fuller; Randal S. Weber; Stephen Y. Lai

doi:10.1002/hed.25156

Incompletely treated malignancies of the major salivary gland: Toward evidence-based care

Samantha Tam, Vlad C. Sandulache, Kareem A. Metwalli, Crosby D. Rock, Salman A. Eraj, Tommy Sheu, Adel K. El-Naggar, Clifton D. Fuller, Randal S. Weber, Stephen Y. Lai

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment-related outcomes for patients with incompletely treated major salivary gland tumors. Methods: A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure. Results: Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P <.001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HR _adjusted ] 2.55; 95% confidence interval [CI] 1.20-5.30; metastatic disease HR _adjusted 9.53; 95% CI 3.04-27.06). Conclusion: Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival.

Original language	English (US)
Pages (from-to)	1630-1638
Number of pages	9
Journal	Head and Neck
Volume	40
Issue number	8
DOIs	https://doi.org/10.1002/hed.25156
State	Published - Aug 2018

Keywords

adjuvant chemotherapy
adjuvant radiotherapy
healthcare delivery
reoperation
salivary gland neoplasms

ASJC Scopus subject areas

Otorhinolaryngology

Access to Document

10.1002/hed.25156

Cite this

@article{915402d26c9e426bafadab13275b8a02,

title = "Incompletely treated malignancies of the major salivary gland: Toward evidence-based care",

abstract = " Background: Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment-related outcomes for patients with incompletely treated major salivary gland tumors. Methods: A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure. Results: Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P <.001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HR adjusted ] 2.55; 95% confidence interval [CI] 1.20-5.30; metastatic disease HR adjusted 9.53; 95% CI 3.04-27.06). Conclusion: Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival.",

keywords = "adjuvant chemotherapy, adjuvant radiotherapy, healthcare delivery, reoperation, salivary gland neoplasms",

author = "Samantha Tam and Sandulache, {Vlad C.} and Metwalli, {Kareem A.} and Rock, {Crosby D.} and Eraj, {Salman A.} and Tommy Sheu and El-Naggar, {Adel K.} and Fuller, {Clifton D.} and Weber, {Randal S.} and Lai, {Stephen Y.}",

note = "Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",

year = "2018",

month = aug,

doi = "10.1002/hed.25156",

language = "English (US)",

volume = "40",

pages = "1630--1638",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "Wiley-Liss Inc.",

number = "8",

}

TY - JOUR

T1 - Incompletely treated malignancies of the major salivary gland

T2 - Toward evidence-based care

AU - Tam, Samantha

AU - Sandulache, Vlad C.

AU - Metwalli, Kareem A.

AU - Rock, Crosby D.

AU - Eraj, Salman A.

AU - Sheu, Tommy

AU - El-Naggar, Adel K.

AU - Fuller, Clifton D.

AU - Weber, Randal S.

AU - Lai, Stephen Y.

PY - 2018/8

Y1 - 2018/8

N2 - Background: Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment-related outcomes for patients with incompletely treated major salivary gland tumors. Methods: A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure. Results: Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P <.001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HR adjusted ] 2.55; 95% confidence interval [CI] 1.20-5.30; metastatic disease HR adjusted 9.53; 95% CI 3.04-27.06). Conclusion: Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival.

AB - Background: Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment-related outcomes for patients with incompletely treated major salivary gland tumors. Methods: A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure. Results: Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P <.001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HR adjusted ] 2.55; 95% confidence interval [CI] 1.20-5.30; metastatic disease HR adjusted 9.53; 95% CI 3.04-27.06). Conclusion: Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival.

KW - adjuvant chemotherapy

KW - adjuvant radiotherapy

KW - healthcare delivery

KW - reoperation

KW - salivary gland neoplasms

UR - http://www.scopus.com/inward/record.url?scp=85046534535&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046534535&partnerID=8YFLogxK

U2 - 10.1002/hed.25156

DO - 10.1002/hed.25156

M3 - Article

C2 - 29734482

AN - SCOPUS:85046534535

SN - 1043-3074

VL - 40

SP - 1630

EP - 1638

JO - Head and Neck

JF - Head and Neck

IS - 8

ER -

Incompletely treated malignancies of the major salivary gland: Toward evidence-based care

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this