PROGNOSTIC FACTORS IN PATIENTS WITH HIGH-RISK LOCALLY ADVANCED SALIVARY GLAND CANCERS TREATED WITH SURGERY AND POSTOPERATIVE RADIOTHERAPY

Background. This study was designed to identify the factors associated with the outcome after standard treat- ment with surgery and postoperative radiotherapy (RT) for locally advanced salivary gland cancers. Methods. We conducted a retrospective review of patients with salivary gland cancers registered in the University of Pitts- burgh databases from 1990 to 2006. Results. A total of 74 patients were analyzed. Histologic types included salivary duct carcinoma, 24%; adenoid cystic carcinoma, 23%; and adenocarcinoma, 19%; N2, 39%; N0-1, 58%; and major salivary gland origin, 80%. With a median fol- low-up of 4.1 years, the 5-year recurrence-free survival (RFS) was 49%, and the 5-year overall survival (OS) was 55%. The 5-year local RFS was 76% and the 5-year distant RFS was 60%. Using Cox-regression analysis, advanced N classification (N2) was the only significant predictor of both RFS and OS. Conclusion. The long-term survival of patients with high- risk, locally advanced salivary gland cancers is unsatisfac- tory. Advanced nodal disease is strongly associated with patient outcome and should be considered as a stratification factor in future trials in locally advanced salivary gland cancers. V C 2011 Wiley Periodicals, Inc. Head Neck 33: 318-323, 2011 Salivary gland cancers arise from either the major (parotid, submandibular, or sublingual) or minor sali- vary glands located within the upper aerodigestive tract. Surgery is the mainstay of treatment; however, the prognosis of patients with salivary gland cancer varies considerably. The clinical behavior of these cancers is dependent upon histology, grade, and