Summary
One hundred and three patients with primary parotid cancer treated surgically at the Christie Hospital, Manchester (1952–1992), were analysed to assess the influence on survival of prognostic and treatment-related factors. Thirty-seven patients were treated by surgery alone (SG), 66 received post-operative radiation (SG+RT). Median follow-up was 12 years, minimum 5 years. The 10-year disease-specific survival rates for stage I, II and III/IV were 96%, 61% and 17% respectively (P < 0.0001). The various histological types segregated into three survival patterns: low-, intermediate-and high-grade with 10-year survival rates of 93%, 41% and 50% respectively (P < 0.0001). On multivariate analysis, the factors influencing risk of cancer death in order of importance were: tumour size > 4 cm (P < 0.001), presence of nodes (P = 0.001), histology of adenoid cystic carcinoma (P = 0.01), high-tumour grade (P = 0.02) and perineural involvement (P = 0.01). Neither the extent of surgery nor the operator influenced outcome. Overall, adjuvant RT significantly reduced locoregional recurrence (SG+RT 15% vs SG 43%; P = 0.002) but not survival, although on subanalysis, there was a trend to improved survival with large cancers and high-grade tumours. Long-term survival is determined primarily by tumour characteristics, namely clinical stage and grade. Post-operative RT contributes significantly to locoregional control and probably confers some survival advantage in high-risk patients.
Change history
16 November 2011
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Armstrong, J. G., Harrison, L. B., Spiro, R. H., Fass, D. E., Strong, E. W. & Fuks, Z. Y. (1990). Malignant tumors of major salivary gland origin. A matched-pair analysis of the role of combined surgery and postoperative radiotherapy. Arch Otolaryngol Head Neck Surg 116: 290–293.
Calearo, C. & Pastore, A. (1995). Parotid carcinoma. In Prognostic Factors in cancer, UICC, Hermanek P, Gospodarowie M, Henson D, Hutter R, Sobins L Springer-Verlag: Berlin. 23–27.
Ellis, G., Auclair, P. & Gnepp, D. (1991). Surgical Pathology of the Salivary Glands. WB Saunders Co: Philadelphia
Fleming, I., Cooper, J., Henson, D., Hutter, R., Kennedy, B. & Murphy, G. (1997). AJCC Cancer Staging Manual. Lippincott-Raven: Philadelphia
Frankenthaler, R. A., Luna, M. A., Lee, S. S., Ang, K. K., Byers, R. M., Guillamondegui, O. M., Wolf, P. & Goepfert, H. (1991). Prognostic variables in parotid gland cancer. Arch Otolaryngol Head Neck Surg 117: 1251–1256.
Gallo, O., Franchi, A., Bottai, G., Fini, STORCHII, Tesi, G. & Boddi, V. (1997). Risk factors for distant metastases from carcinoma of the parotid gland. Cancer 80: 844–851.
HMSO (1997). Cancer Statistics Registrations 1991. Series MB1 no. 24. pp24. Office for National Statistics: London
Jackson, G., Luna, M. & Byers, R. (1983). Results of surgery alone and surgery combined with postoperative radiotherapy in the treatment of cancer of the parotid gland. Am J Surg 146: 697–700.
Kane, W. J., McCaffrey, T. V., Olsen, K. D. & Lewis, J. E. (1991). Primary parotid malignancies. A clinical and pathologic review. Arch Otolaryngol Head Neck Surg 117: 307–315.
Leverstein, H., van der Waal, J. E., Tiwari, R. M., Tobi, H., van der Waal, I., Mehta, D. M. & Snow, G. B. (1998). Malignant epithelial parotoid gland tumours: analysis and results in 65 previously untreated patients. Br J Surg 85: 1267–1272.
McGurk, M., Renehan, A., Gleave, E. N. & Hancock, B. D. (1996). Clinical significance of the tumour capsule in the treatment of parotid plemorphic adenomas. Br J Surg 83: 1747–1749.
McGurk, M., Williams, R. & Calman, F. (1995). A Clinical Approach to Malignant Tumours. In Colour Atlas and Text of Salivary Glands: Diseases, Disorders and Surgery, de Norman J, McGurk M, Mosby-Wolf: London 181–196.
Overgaard, M., Hansen, P. S., Overgaard, J., Rose, C., Andersson, M., Bach, F., Kjaer, M., Gadeberg, C. C., Mouridsen, H. T., Jensen, M. B. & Zedeler, K. (1997). Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial [see comments]. N Engl J Med 337: 949–955.
Renehan, A., Gleave, E. N., Hancock, B. D., Smith, P. & McGurk, M. (1996). Long-term follow-up of over 1000 patients with salivary gland tumours treated in a single centre. Br J Surg 83: 1750–1754.
Robbins, K., JE, M., Wolfe, G., Levine, P., RB, S. & Pruet, C. (1991). Standardizing neck dissection terminology. Official report of the Academy’s committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg 117: 601–605.
Seifert, G. & Sobin, L. (1991). WHO Histological Typing of Salivary Gland Tumours. Springer-Verlag: Berlin.
Spiro, R. H. (1986). Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg 8: 177–184.
Spiro, R. H., Armstrong, J., Harrison, L., Geller, N. L., Lin, S-Y & Strong, E. W. (1989). Carcinoma of major salivary glands. Recent Trends Arch Otolaryngol Head Neck Surg 115: 316–321.
Spiro, R. H. & Huvos, A. G. (1992). Stage means more than grade in adenoid cystic carcinoma. Am J Surg 164: 623–628.
Spiro, I. J., Wang, C. C. & Montgomery, W. W. (1993). Carcinoma of the parotid gland. Analysis of treatment results and patterns of failure after combined surgery and radiation therapy. Cancer 71: 2699–2705.
Sykes, A. J., Logue, J. P., Slevin, N. J. & Gupta, N. K. (1995). An analysis of radiotherapy in the management of 104 patients with parotid carcinoma. Clin Oncol R Coll Radiol 7: 16–20.
Theriault, C. & Fitzpatrick, P. J. (1986). Malignant parotid tumors. Prognostic factors and optimum treatment. Am J Clin Oncol 9: 510–516.
Author information
Authors and Affiliations
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Renehan, A., Gleave, E., Slevin, N. et al. Clinico-pathological and treatment-related factors influencing survival in parotid cancer. Br J Cancer 80, 1296–1300 (1999). https://doi.org/10.1038/sj.bjc.6990501
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bjc.6990501
Keywords
- parotid carcinoma
- prognostic factors
- surgery
- radiotherapy
This article is cited by
-
Clinical value of adjuvant therapy on the prognosis of ductal carcinoma of the major salivary gland: a large-scale cohort study
European Archives of Oto-Rhino-Laryngology (2023)
-
Challenges with preoperative diagnosis of low/intermediate-grade carcinoma of the parotid gland: single-center study of 112 patients
European Archives of Oto-Rhino-Laryngology (2020)
-
Kaplan–Meier analysis of salivary gland tumors: prognosis and long-term survival
Journal of Cancer Research and Clinical Oncology (2019)
-
Primary parotid carcinoma: analysis of risk factors and validation of a prognostic index
European Archives of Oto-Rhino-Laryngology (2018)
-
Significant prognostic factors affecting treatment outcomes of salivary gland carcinoma: a multicenter retrospective analysis
Odontology (2018)
