Prognostic significance and optimal candidates of primary tumor resection in major salivary gland carcinoma patients with distant metastases at initial presentation: A population-based study

Xiao Shi, Fan Dong, Wenjun Wei, Kehan Song, Naisi Huang, Zhongwu Lu, Bowen Lei, Pengcheng Yu, Wanlin Liu, Yu Wang, Guohua Sun, Yulong Wang, Qinghai Ji

Research output: Contribution to journalArticle

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Abstract

Objectives: To investigate the prognostic significance and identify optimal candidates of primary tumor resection (PTR) for patients with metastatic major salivary gland carcinoma (MaSGC) at diagnosis. Materials and methods: Patients with metastatic MaSGC were identified from the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier analyses, log-rank tests and multivariate Cox regression models were employed to evaluate the therapeutic roles of PTR in the overall cohort and different subgroups. Results: Overall, 255 patients were included in our study, among whom 80 (31.4%) received PTR. PTR was associated with decreased overall mortality (OM) and cancer-specific mortality (CSM) in the overall cohort (PTR vs No-PTR, HR: 0.363, 95%CI: 0.204–0.646, p =.001 for OM; HR: 0.439, 95%CI: 0.243–0.794, p =.006 for CSM). When we focused on site-specific metastases, receipt of PTR significantly reduced the risk of OM for patients with lung, bone or distant lymph node involvement (all p <.05), whereas this surgical procedure not only failed to bring survival benefit, but even seemed to insignificantly increase the mortality risk once liver metastases were presented (PTR vs No-PTR, HR: 1.109, 95%CI: 0.279–4.412 for OM; HR: 1.596, 95%CI: 0.364–7.004 for CSM). In addition, subgroup analyses showed that patients with stage T1-3 disease, younger age (<65), single-site metastases and high-risk pathologies might benefit from PTR. Conclusion: Our study for the first time verifies the favorable prognostic impact of PTR for highly-selected patients with metastatic MaSGC at diagnosis and has the potential to be adopted in future clinical practice, although long-term prospective studies are warranted.

Original languageEnglish (US)
Pages (from-to)87-93
Number of pages7
JournalOral Oncology
Volume78
DOIs
StatePublished - Mar 1 2018

Fingerprint

Salivary Glands
Neoplasm Metastasis
Carcinoma
Population
Neoplasms
Mortality
Kaplan-Meier Estimate
Proportional Hazards Models
Epidemiology
Lymph Nodes
Databases
Prospective Studies

Keywords

  • Major salivary gland carcinoma
  • Metastatic site
  • Optimal candidates
  • Primary tumor resection

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

Prognostic significance and optimal candidates of primary tumor resection in major salivary gland carcinoma patients with distant metastases at initial presentation : A population-based study. / Shi, Xiao; Dong, Fan; Wei, Wenjun; Song, Kehan; Huang, Naisi; Lu, Zhongwu; Lei, Bowen; Yu, Pengcheng; Liu, Wanlin; Wang, Yu; Sun, Guohua; Wang, Yulong; Ji, Qinghai.

In: Oral Oncology, Vol. 78, 01.03.2018, p. 87-93.

Research output: Contribution to journalArticle

Shi, Xiao ; Dong, Fan ; Wei, Wenjun ; Song, Kehan ; Huang, Naisi ; Lu, Zhongwu ; Lei, Bowen ; Yu, Pengcheng ; Liu, Wanlin ; Wang, Yu ; Sun, Guohua ; Wang, Yulong ; Ji, Qinghai. / Prognostic significance and optimal candidates of primary tumor resection in major salivary gland carcinoma patients with distant metastases at initial presentation : A population-based study. In: Oral Oncology. 2018 ; Vol. 78. pp. 87-93.
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abstract = "Objectives: To investigate the prognostic significance and identify optimal candidates of primary tumor resection (PTR) for patients with metastatic major salivary gland carcinoma (MaSGC) at diagnosis. Materials and methods: Patients with metastatic MaSGC were identified from the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier analyses, log-rank tests and multivariate Cox regression models were employed to evaluate the therapeutic roles of PTR in the overall cohort and different subgroups. Results: Overall, 255 patients were included in our study, among whom 80 (31.4{\%}) received PTR. PTR was associated with decreased overall mortality (OM) and cancer-specific mortality (CSM) in the overall cohort (PTR vs No-PTR, HR: 0.363, 95{\%}CI: 0.204–0.646, p =.001 for OM; HR: 0.439, 95{\%}CI: 0.243–0.794, p =.006 for CSM). When we focused on site-specific metastases, receipt of PTR significantly reduced the risk of OM for patients with lung, bone or distant lymph node involvement (all p <.05), whereas this surgical procedure not only failed to bring survival benefit, but even seemed to insignificantly increase the mortality risk once liver metastases were presented (PTR vs No-PTR, HR: 1.109, 95{\%}CI: 0.279–4.412 for OM; HR: 1.596, 95{\%}CI: 0.364–7.004 for CSM). In addition, subgroup analyses showed that patients with stage T1-3 disease, younger age (<65), single-site metastases and high-risk pathologies might benefit from PTR. Conclusion: Our study for the first time verifies the favorable prognostic impact of PTR for highly-selected patients with metastatic MaSGC at diagnosis and has the potential to be adopted in future clinical practice, although long-term prospective studies are warranted.",
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T1 - Prognostic significance and optimal candidates of primary tumor resection in major salivary gland carcinoma patients with distant metastases at initial presentation

T2 - A population-based study

AU - Shi, Xiao

AU - Dong, Fan

AU - Wei, Wenjun

AU - Song, Kehan

AU - Huang, Naisi

AU - Lu, Zhongwu

AU - Lei, Bowen

AU - Yu, Pengcheng

AU - Liu, Wanlin

AU - Wang, Yu

AU - Sun, Guohua

AU - Wang, Yulong

AU - Ji, Qinghai

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objectives: To investigate the prognostic significance and identify optimal candidates of primary tumor resection (PTR) for patients with metastatic major salivary gland carcinoma (MaSGC) at diagnosis. Materials and methods: Patients with metastatic MaSGC were identified from the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier analyses, log-rank tests and multivariate Cox regression models were employed to evaluate the therapeutic roles of PTR in the overall cohort and different subgroups. Results: Overall, 255 patients were included in our study, among whom 80 (31.4%) received PTR. PTR was associated with decreased overall mortality (OM) and cancer-specific mortality (CSM) in the overall cohort (PTR vs No-PTR, HR: 0.363, 95%CI: 0.204–0.646, p =.001 for OM; HR: 0.439, 95%CI: 0.243–0.794, p =.006 for CSM). When we focused on site-specific metastases, receipt of PTR significantly reduced the risk of OM for patients with lung, bone or distant lymph node involvement (all p <.05), whereas this surgical procedure not only failed to bring survival benefit, but even seemed to insignificantly increase the mortality risk once liver metastases were presented (PTR vs No-PTR, HR: 1.109, 95%CI: 0.279–4.412 for OM; HR: 1.596, 95%CI: 0.364–7.004 for CSM). In addition, subgroup analyses showed that patients with stage T1-3 disease, younger age (<65), single-site metastases and high-risk pathologies might benefit from PTR. Conclusion: Our study for the first time verifies the favorable prognostic impact of PTR for highly-selected patients with metastatic MaSGC at diagnosis and has the potential to be adopted in future clinical practice, although long-term prospective studies are warranted.

AB - Objectives: To investigate the prognostic significance and identify optimal candidates of primary tumor resection (PTR) for patients with metastatic major salivary gland carcinoma (MaSGC) at diagnosis. Materials and methods: Patients with metastatic MaSGC were identified from the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier analyses, log-rank tests and multivariate Cox regression models were employed to evaluate the therapeutic roles of PTR in the overall cohort and different subgroups. Results: Overall, 255 patients were included in our study, among whom 80 (31.4%) received PTR. PTR was associated with decreased overall mortality (OM) and cancer-specific mortality (CSM) in the overall cohort (PTR vs No-PTR, HR: 0.363, 95%CI: 0.204–0.646, p =.001 for OM; HR: 0.439, 95%CI: 0.243–0.794, p =.006 for CSM). When we focused on site-specific metastases, receipt of PTR significantly reduced the risk of OM for patients with lung, bone or distant lymph node involvement (all p <.05), whereas this surgical procedure not only failed to bring survival benefit, but even seemed to insignificantly increase the mortality risk once liver metastases were presented (PTR vs No-PTR, HR: 1.109, 95%CI: 0.279–4.412 for OM; HR: 1.596, 95%CI: 0.364–7.004 for CSM). In addition, subgroup analyses showed that patients with stage T1-3 disease, younger age (<65), single-site metastases and high-risk pathologies might benefit from PTR. Conclusion: Our study for the first time verifies the favorable prognostic impact of PTR for highly-selected patients with metastatic MaSGC at diagnosis and has the potential to be adopted in future clinical practice, although long-term prospective studies are warranted.

KW - Major salivary gland carcinoma

KW - Metastatic site

KW - Optimal candidates

KW - Primary tumor resection

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