Carcinoma of the major and minor salivary glands. Analysis of treatment results and sites and causes of failures

Abstract

Treatment results of 100 cases of previously untreated malignant epithelial tumors of the major and minor salivary glands were analyzed with respect to stage, treatment modality and histology. For carcinoma of the parotid gland, the 5‐ and 10‐year determinate survivals decreased from 88% and 83% for Stage I disease to 76% and 76% for Stage II, to 49% and 32% for Stage III and 0% for Stage IV disease. The 5‐ and 10‐year determinate survivals were 96% and 96% for mucoepidermoid carcinoma, 80% and 80% for acinic cell carcinoma, 72% and 62% for adenocarcinoma, 57% and 57% for squamous cell carcinoma, 65% and 29% for adenoid cystic carcinoma and 44% and 22% for undifferentiated carcinoma. Postoperative radiotherapy improved the local control rates of adenoid cystic carcinoma and advanced local disease, its effectiveness related directly to the extent of tumor present. Radiotherapy was highly effective for microscopic disease and the incidence of local recurrence was 14% for patients who received postoperative radiotherapy and 54% for those who did not when there was known microscopic disease at or close to surgical margin. No significant difference in response to radiotherapy was seen between the different histological types. Most failures occurred at the primary tumor site or at the site of distant metastasis, whereas failure in regional lymph nodes was uncommon. When the cause of failure could be determined, it most often appeared to have been tumor remaining at the surgical margin with no postoperative radiotherapy given. Cancer 40:2882‐2890, 1977. Copyright © 1977 American Cancer Society