Secretory carcinoma of the salivary gland: A multi-institutional clinicopathologic study of 90 cases with emphasis on grading and prognostic factors Journal Article

   

Authors:	Xu, B.; Viswanathan, K.; Umrau, K.; Al-Ameri, T. A. D.; Dogan, S.; Magliocca, K.; Ghossein, R. A.; Cipriani, N. A.; Katabi, N.
Article Title:	Secretory carcinoma of the salivary gland: A multi-institutional clinicopathologic study of 90 cases with emphasis on grading and prognostic factors
Abstract:	Secretory carcinoma (SC) is a rare form of salivary carcinoma that was first described in 2010 and is characterized by ETV6::NTRK3 fusion in most cases. In this large retrospective study, we aimed to identify adverse clinicopathologic factors and propose a prognostically relevant grading scheme for SC. Methods: A detailed clinicopathologic review was conducted on 90 SCs from the major and minor salivary glands. Results: The median age at presentation was 50 years (range: 7–93). Sixty-nine (77%) tumours originated from major salivary glands, whereas the remaining 21 involved minor salivary glands.Six cases (7%) had cervical nodal metastasis. Only lymphovascular invasion (LVI) was associated with a risk of nodal metastasis (P < 0.05). The 5-year disease-specific survival and disease-free survival (DFS) were 98% and 87%, respectively. On univariate survival analysis, adverse prognostic factors associated with decreased DFS included minor salivary gland origin, atypical mitosis, high mitotic index, high-grade transformation (HGT), necrosis, nuclear pleomorphism, infiltrative tumour border, fibrosis at the invasive front, LVI, positive margin, and advanced pT stage (P < 0.05). When adjusted for pT stage and margin status, mitotic index, LVI, nuclear pleomorphism, and HGT remained as independent prognostic factors. Conclusion: We therefore propose a two-tiered grading system for SC. The low-grade SC is defined as those with <5 mitoses /10 high-power fields and no tumour necrosis, and high-grade SC as those with ≥5 mitoses /10 high-power fields and/or necrosis. This proposed grading system can be useful to risk stratify patients with SC for appropriate clinical management. © 2022 John Wiley & Sons Ltd.
Keywords:	immunohistochemistry; adolescent; adult; child; human tissue; aged; aged, 80 and over; middle aged; survival analysis; retrospective studies; young adult; oncoprotein; major clinical study; clinical trial; disease course; disease free survival; follow up; cancer grading; pathology; breast neoplasms; retrospective study; necrosis; multicenter study; breast tumor; oncogene proteins, fusion; carcinoma; cytoplasm; salivary gland; salivary gland tumor; salivary gland neoplasms; salivary glands; disease specific survival; salivary gland carcinoma; mitosis index; grading; cancer prognosis; minor saliva gland; lymph vessel metastasis; distant metastasis free survival; secretory carcinoma; very elderly; humans; prognosis; human; male; female; article; etv6::ntrk3 fusion
Journal Title:	Histopathology
Volume:	81
Issue:	5
ISSN:	0309-0167
Publisher:	Wiley Blackwell
Date Published:	2022-11-01
Start Page:	670
End Page:	679
Language:	English
DOI:	10.1111/his.14772
PUBMED:	35974431
PROVIDER:	scopus
PMCID:	PMC9580072
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137339119&doi=10.1111%2fhis.14772&partnerID=40&md5=32f0c1db379f1fece2f88f1b8d00fca0
Notes:	Article -- Export Date: 1 November 2022 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/199312