Clinical and pathologic prognostic features in acinic cell carcinoma of the parotid gland Journal Article

Authors: Gomez, D. R.; Katabi, N.; Zhung, J.; Wolden, S. L.; Zelefsky, M. J.; Kraus, D. H.; Shah, J. P.; Wong, R. J.; Ghossein, R. A.; Lee, N. Y.
Article Title: Clinical and pathologic prognostic features in acinic cell carcinoma of the parotid gland
Abstract: BACKGROUND: To the authors' knowledge, the indications for adjuvant treatment in acinic cell carcinoma (AciCC) of the parotid gland have not been elucidated to date. The aim of the current study was to determine patterns of failure and adverse prognostic features. METHODS: Between March of 1989 and August of 2006, 35 patients underwent surgery at Memorial Sloan-Kettering Cancer Center for AciCC of the parotid gland and had their clinical and pathologic features retrospectively analyzed at the primary site. All cases were reviewed by 2 head and neck pathologists. Five-year estimates of survival outcomes were performed, followed by univariate analysis of potential prognostic features. RESULTS: The T classifications were as follows: T1 in 46% of patients, T2 in 23% of patients, T3 in 18% of patients, and T4 in 9% of patients. Three patients had cervical lymph node involvement. All patients underwent surgery as their primary treatment. Approximately 63% of patients (n = 22) received radiation treatment. The median follow-up time for surviving patients was 59.9 months. Five-year estimates of disease-free survival (DFS), overall survival (OS), and local controlwere 85%, 90%, and 90%, respectively. Of the clinical variables tested, clinical extracapsular extension (ECE), facial nerve sacrifice, and lymph node involvement were found to be significantly associated with a detriment in DFS and OS (P < .05). Positive surgical margins, histologic ECE, >2 mitoses per 10 high-power fields (HPF), atypical mitosis, vascular invasion, perineural invasion, pleomorphism, and necrosis were associated with adverse DFS (P < .05). All of these variables except for vascular invasion (P = .377) and perineural invasion (P=.07) were associated with OS. If high-grade tumorswere defined on the basis of high mitotic activity (>2 mitoses/10 HPF) and/or tumor necrosis, high-grade carcinomas had a significantly lower DFS and OS (P =.001). CONCLUSIONS: AciCC had a low treatment failure rate, and a large number of patients could be considered candidates for surgery only. A histologic grading system was devised to help stratify patients for adjuvant treatment. © 2009 American Cancer Society.
Keywords: adult; clinical article; human tissue; disease-free survival; middle aged; cancer surgery; surgical technique; treatment failure; overall survival; clinical feature; cancer localization; cancer combination chemotherapy; cancer patient; cancer radiotherapy; disease free survival; postoperative care; radiation dose; combined modality therapy; cancer staging; follow up; cancer grading; neoplasm recurrence, local; esophagitis; mucosa inflammation; graft necrosis; retrospective study; cancer invasion; survival time; cancer center; neoplasm metastasis; xerostomia; radiation therapy; salivary gland tumor; dermatitis; cancer classification; cancer control; cervical lymph node; univariate analysis; acinar cell carcinoma; carcinoma, acinar cell; postoperative pain; acinic cell carcinoma; histologic grading system; parotid gland; prognostic features; facial nerve paralysis; hearing disorder; parotid gland carcinoma; pathologist; trismus; visual impairment; facial nerve injuries; parotid neoplasms
Journal Title: Cancer
Volume: 115
Issue: 10
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2009-05-15
Start Page: 2128
End Page: 2137
Language: English
DOI: 10.1002/cncr.24259
PUBMED: 19309749
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: CANCA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Michael J Zelefsky
    692 Zelefsky
  2. Dennis Kraus
    268 Kraus
  3. Ronald A Ghossein
    363 Ghossein
  4. Suzanne L Wolden
    482 Wolden
  5. Daniel R Gomez
    79 Gomez
  6. Nancy Y. Lee
    684 Lee
  7. Nora Katabi
    239 Katabi
  8. Richard J Wong
    284 Wong
  9. Jatin P Shah
    636 Shah
  10. Joanne Zhung
    12 Zhung