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December 20, 2010

Factors Predicting Outcome in Malignant Minor Salivary Gland Tumors of the Oropharynx

Author Affiliations

Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Otolaryngol Head Neck Surg. 2010;136(12):1240-1247. doi:10.1001/archoto.2010.213

Objectives  To report our experience in the care of patients with minor salivary gland cancers occurring only in the oropharynx and to determine factors predictive of outcome.

Design  Retrospective analysis.

Setting  Memorial Sloan-Kettering Cancer Center.

Patients  Sixty-seven patients with malignant minor salivary gland tumors were identified from a preexisting database of patients with cancers of the oropharynx between January 1985 and December 2005.

Main Outcome Measures  Overall survival, disease-specific survival, and recurrence-free survival were calculated by the Kaplan-Meier method. Factors predictive of outcome were identified by univariate and multivariate analyses.

Results  The most common histologic types were mucoepidermoid carcinoma in 26 patients (39%), adenoid cystic carcinoma in 16 (24%), adenocarcinoma in 16 (24%), and malignant mixed tumor in 7 (10%). The tumors were located in the base of the tongue in 41 patients (61%), soft palate in 20 (30%), and tonsil in 6 (9%). With a median follow-up time of 86 months (range, 12-249 months), overall outcomes at 5 and 10 years were overall survival, 80% and 53%; disease-specific survival, 87% and 67%; and recurrence-free survival, 69% and 60%, respectively. Tumor recurred in 20 patients (34%); 12 of these patients had locoregional failure and 15 developed distant metastases. Multivariate analyses showed that clinical T stage, anatomic subsite, and margin status were independent predictors for overall survival; T stage and margin status were independent predictors for locoregional recurrence-free survival.

Conclusion  Clinical T stage, anatomic subsite, and margin status are independent predictors of outcome of patients with minor salivary gland cancers of the oropharynx.