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Adjuvant therapy in the management of operable salivary duct carcinoma: correlating evidence with a retrospective review

Published online by Cambridge University Press:  10 February 2021

Jeyaanth Venkatasai
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Anindita Das
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Punitha Kaliamurthi
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Balu Krishna Sasidharan*
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Manu Mathew
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Ashish Singh
Affiliation:
Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu 632004, India
Aparna Irodi
Affiliation:
Division of Clinical Radiology, Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu 632004, India
Meera Thomas
Affiliation:
Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu 632004, India
Subhashini John
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Rajiv C. Michael
Affiliation:
Department of Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu 632004, India
Amit J. Tirkey
Affiliation:
Department of Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu 632004, India
Rajesh Isiah
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
Simon Pavamani
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India
*
Author for correspondence: Balu Krishna Sasidharan, Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu 632004, India. Tel: 0416-228-2046; Mobile: +919626262296. E-mail: balunair@cmcvellore.ac.in

Abstract

Background:

Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary gland cancer with high morbidity and mortality and poor response to treatment. The current options of treatment include radical surgery followed by radiotherapy (RT) with or without chemotherapy. The aim of this study was to analyse the patterns of recurrences, possible predictors of outcome and role of RT in a cohort of patients with non-metastatic SDC.

Methods:

A retrospective review of patients treated between 2010 and 2019 with histologically proven non-metastatic SDC was conducted.

Results:

Sixteen patients were included in the series. Median follow-up was 25 months. Progression-free survival (PFS) and overall survival (OS) at 12 months were 61% and 80%, respectively. Seven out of the 16 patients had disease progression, distant metastases being most frequent. Four patients died due to disease progression. PFS was significantly worse for patients with pathological neck node positivity (p = 0·036) and peri-parotid nodes (p = 0·007). Local control was significantly associated with RT (p = 0·011). Addition of any chemotherapy, regardless of either concurrent or adjuvant, had no impact on the PFS or OS. Pathological neck node positivity with nodal stage of N2 or higher correlated significantly with worse OS (p = 0·031).

Conclusion:

Salivary ductal carcinoma is an aggressive malignancy with high metastatic potential. Inferior prognosis was observed among patients who had metastatic deposits in either cervical nodes or peri-parotid nodes on histopathology. As systemic failures are more predominant among these patients, larger prospective trials are needed to formulate an optimum strategy for choice and sequencing of first-line systemic therapy.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Bray, F, Ferlay, J, Soerjomataram, I, Siegel, RL, Torre, LA, Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394424.CrossRefGoogle ScholarPubMed
Jaehne, M, Röser, K, Jaekel, T, Schepers, JD, Albert, NT, Loening, T. Clinical and immunohistologic typing of salivary duct carcinoma: a report of 50 cases. Cancer 2005; 103 (12): 25262533.CrossRefGoogle ScholarPubMed
Gilbert, MR, Sharma, A, Schmitt, N et al. A 20-year review of 75 cases of salivary duct carcinoma. JAMA Otolaryngol – Head Neck Surg 2016; 142 (5): 489495.CrossRefGoogle ScholarPubMed
Sood, S, McGurk, M, Vaz, F. Management of salivary gland tumours: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130: S142S149.CrossRefGoogle ScholarPubMed
Pons, Y, Alves, A, Clément, P, Conessa, C. Salivary duct carcinoma of the parotid. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128: 194196.CrossRefGoogle ScholarPubMed
Amini, A, Waxweiler, TV, Brower, JV et al. Association of adjuvant chemoradiotherapy vs radiotherapy alone with survival in patients with resected major salivary gland carcinoma: data From the National Cancer Data Base. JAMA Otolaryngol Neck Surg 2016; 142: 11001110.CrossRefGoogle ScholarPubMed
Fan, CY, Melhem, MF, Hosal, AS, Grandis, JR, Barnes, EL. Expression of androgen receptor, epidermal growth factor receptor, and transforming growth factor alpha in salivary duct carcinoma. Arch Otolaryngol Head Neck Surg 2001; 127: 10751079.CrossRefGoogle ScholarPubMed
Williams, MD, Roberts, D, Blumenschein, GR et al. Differential expression of hormonal and growth factor receptors in salivary duct carcinomas: biologic significance and potential role in therapeutic stratification of patients. Am J Surg Pathol 2007; 31: 16451652.CrossRefGoogle ScholarPubMed
Williams, MD, Roberts, DB, Kies, MS, Mao, L, Weber, RS, El-Naggar, AK. Genetic and Expression Analysis Of HER-2 and EGFR genes in salivary duct carcinoma: empirical and therapeutic significance. Clin Cancer Res Off J Am Assoc Cancer Res 2010; 16: 22662274.CrossRefGoogle ScholarPubMed
Kumar, RV, Kini, L, Bhargava, AK et al. Salivary duct carcinoma. J Surg Oncol 1993; 54: 193198.CrossRefGoogle ScholarPubMed
Prabhash, K, Babu, G, Chaturvedi, P et al. Indian clinical practice consensus guidelines for the management of squamous cell carcinoma of head and neck. Indian J Cancer 2020; 57: 1.CrossRefGoogle ScholarPubMed
Shah, SB, Sharma, S, D’Cruz, AK. Head and neck oncology: The Indian scenario. South Asian J Cancer 2016; 5: 104105.Google ScholarPubMed
Cox, JD, Stetz, J, Pajak, TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995; 31 (5): 13411346.CrossRefGoogle Scholar
Kleinsasser, O, Klein, HJ, Hübner, G. Salivary duct carcinoma - A group of salivary gland tumors analogous to mammary duct carcinoma. Arch Klin Exp Ohren Nasen Kehlkopfheilkd (German) 1968; 192: 100105.CrossRefGoogle ScholarPubMed
Osborn, V, Givi, B, Lee, A et al. Characterization, treatment and outcomes of salivary ductal carcinoma using the National Cancer Database. Oral Oncol 2017; 71: 4146.CrossRefGoogle ScholarPubMed
Jayaprakash, V, Merzianu, M, Warren, GW et al. Survival rates and prognostic factors for infiltrating salivary duct carcinoma: analysis of 228 cases from the Surveillance, Epidemiology, and End Results database. Head Neck 2014; 36: 694701.CrossRefGoogle ScholarPubMed
Mifsud, MJ, Burton, JN, Trotti, AM, Padhya, TA. Multidisciplinary management of salivary gland cancers. Cancer Control J Moffitt Cancer Cent 2016; 23: 242248.CrossRefGoogle ScholarPubMed
Stodulski, D, Mikaszewski, B, Majewska, H, Kuczkowski, J. Parotid salivary duct carcinoma: a single institution’s 20-year experience. Eur Arch Otorhinolaryngol 2019; 276 (7): 20312038.CrossRefGoogle ScholarPubMed
Qian, K, Di, L, Guo, K, Zheng, X, Ji, Q, Wang, Z. Cervical lymph node metastatic status and adjuvant therapy predict the prognosis of salivary duct carcinoma. J Oral Maxillofac Surg 2018; 76 (7): 15781586.CrossRefGoogle ScholarPubMed
Rodriguez, C, El-Naggar, A, Blvd, H. A Randomized Phase II Study Of Adjuvant Concurrent Radiation And Chemotherapy Versus Radiation Alone In Resected High-Risk Malignant Salivary Gland Tumors. ClinicalTrials.gov Identifier: NCT01220583. https://clinicaltrials.gov/ct2/show/NCT01220583. Accessed on 21st August 2020.Google Scholar
Groupe Oncologie Radiotherapie Tete et Cou. A Phase III Randomized Study of Chemo-Radiotherapy Versus Radiotherapy Alone in the Adjuvant Treatment of Salivary Glands and Nasal Tumors (IMRT or Proton therapy) [SANTAL]. ClinicalTrials.gov Identifier: NCT02998385. https://clinicaltrials.gov/ct2/show/NCT02998385. Accessed on 21st August 2020.Google Scholar
Walvekar, RR, Filho, PAA, Seethala, RR et al. Clinicopathologic features as stronger prognostic factors than histology or grade in risk stratification of primary parotid malignancies. Head Neck 2011; 33: 225231.CrossRefGoogle ScholarPubMed
Roh, J-L, Lee, J-I, Choi, S-H et al. Prognostic factors and oncologic outcomes of 56 salivary duct carcinoma patients in a single institution: high rate of systemic failure warrants targeted therapy. Oral Oncol 2014; 50: e64e66.CrossRefGoogle Scholar
Johnston, ML, Huang, SH, Waldron, JN et al. Salivary duct carcinoma: treatment, outcomes, and patterns of failure. Head Neck 2016; 38: E820E826.CrossRefGoogle ScholarPubMed
Otsuka, K, Imanishi, Y, Tada, Y et al. Clinical outcomes and prognostic factors for salivary duct carcinoma: a multi-institutional analysis of 141 patients. Ann Surg Oncol 2016; 23: 20382045.CrossRefGoogle ScholarPubMed
Boon, E, Bel, M, van Boxtel, W et al. A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands. Int J Cancer 2018; 143: 758766.CrossRefGoogle ScholarPubMed
Lee, DS, Lee, CG, Keum, KC et al. Treatment outcomes of patients with salivary duct carcinoma undergoing surgery and postoperative radiotherapy. Acta Oncol 2020; 59 (5): 565568.CrossRefGoogle ScholarPubMed
Udager, AM, Chiosea, SI. Salivary duct carcinoma: an update on morphologic mimics and diagnostic use of androgen receptor immunohistochemistry. Head Neck Pathol 2017; 11: 288294.CrossRefGoogle ScholarPubMed
Hanna, GJ, Bae, JE, Lorch, JH et al. The benefits of adjuvant trastuzumab for salivary gland cancers. The Oncologist 2020; 25: 598608.CrossRefGoogle ScholarPubMed
Boxtel, W van, Verhaegh, GW, Grunsven, IA van E et al. Prediction of clinical benefit from androgen deprivation therapy in salivary duct carcinoma patients. Int J Cancer 2020; 146: 31963206.CrossRefGoogle ScholarPubMed
Fushimi, C, Tada, Y, Takahashi, H et al. A prospective phase II study of combined androgen blockade in patients with androgen receptor-positive metastatic or locally advanced unresectable salivary gland carcinoma. Ann Oncol 2018; 29: 979984.CrossRefGoogle ScholarPubMed
Han, MW, Roh, J-L, Choi, S-H et al. Prognostic factors and outcome analysis of salivary duct carcinoma. Auris Nasus Larynx 2015; 42: 472477.CrossRefGoogle ScholarPubMed
Sato, F, Akiba, J, Kawahara, A et al. The expression of programed death ligand-1 could be related with unfavorable prognosis in salivary duct carcinoma. J Oral Pathol Med 2018; 47: 683690.CrossRefGoogle ScholarPubMed
Hamza, A, Roberts, D, Su, S, Weber, RS, Bell, D, Ferrarotto, R. PD-L1 expression by immunohistochemistry in salivary duct carcinoma. Ann Diagn Pathol 2019; 40: 4952.CrossRefGoogle ScholarPubMed

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