Clinical investigation on distant metastases of salivary gland carcinoma after being treated by surgery combined with 125I internal brachytherapy

Objective: To investigate clinical features of distant metastases( DM) and analyze clinicopathologic risk factors associated with DM from salivary gland carcinomas after being treated by surgery combined with125 I internal brachytherapy. Methods: Between October 2001 and March 2010,197 patients with salivary gland carcinoma were treated by surgery combined with125 I internal brachytherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate clinicopathologic risk factors that might influence the risk of distant metastases. Results: DM occurred in 28 of197 patients( 14. 2%). The commonest site of distant metastases overall was the lung 89. 3%( 25 /28),followed by bones 17. 9%( 5 /28) and liver( 4 /28). DM developed after an average interval of( 44. 2 ±45. 8) months from the time of initial diagnosis,and the mean interval was 64 months. The average time to death after the diagnosis of DM was only( 9. 7 ± 13. 4) months,and the mean time was 12 months.The 3-year locoregional control rate and survival rate were 90. 8%,and 87. 8% respectively,and the 5-year ones 84. 0% and 81. 0%,respectively. Univariate analyses revealed that the risk of distant metastases was significantly influenced by locoregional tumor failure( F = 26. 997,P 0. 01) and histologic differentiation( F = 1. 592,P 0. 01). Multivariate analysis of freedom from distant metastases revealed that locoregional control( F = 29. 332,P 0. 01) significantly influenced this end point. Conclusion: Salivary gland carcinoma could achieve high local control rate after being treated by surgery combined with125 I internal brachytherapy,and the average interval from diagnosis to DM was prolonged,DM was significantly influenced bylocoregional control.