A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands
Boon, Eline; Bel, Miranda; van Boxtel, Wim; van der Graaf, Winette T.A.; van Es, Robert J.J.; Eerenstein, Simone E.J.; Baatenburg de Jong, Robert J.; van den Brekel, Michiel W.M.; van der Velden, Lilly Ann; Witjes, Max J.H.; Hoeben, Ann; Willems, Stefan M.; Bloemena, Elisabeth; Smit, Laura A.; Oosting, Sjoukje F.; Jonker, Marianne A.; Flucke, Uta E.; van Herpen, Carla M.L.
(2018) International Journal of Cancer, volume 143, issue 4, pp. 758 - 766
(Article)
Abstract
Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression.
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SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in-situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and-to a lesser extent-HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting.
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Keywords: Androgen receptors, ErbB-2, Fluorescence, Immunohistochemistry, in situ hybridization, Prognosis, Receptor, Salivary duct carcinoma, Salivary gland neoplasms, Survival, androgen receptors, salivary duct carcinoma, survival, salivary gland neoplasms, prognosis, receptor, fluorescence, immunohistochemistry, Recurrence, Humans, Middle Aged, Male, Palliative Care, Chemoradiotherapy, Adjuvant, Neoplasm Metastasis, Netherlands, Carcinoma/pathology, Aged, 80 and over, Adult, Female, Salivary Gland Neoplasms/pathology, Receptor, ErbB-2/metabolism, Salivary Ducts/pathology, Survival Rate, Factor Analysis, Statistical, Lymphatic Metastasis, Disease-Free Survival, Aged, Receptors, Androgen/metabolism, Oncology, Cancer Research, Journal Article
ISSN: 0020-7136
Publisher: John Wiley & Sons Inc.
Note: Funding Information: The authors thank M. Tomassen for his extensive help during pathological revision and construction of the TMAs. They thank P. J. Slootweg for his consultation on ambiguous cases of SDC. They also thank all participating pathologists and clinicians for their contribution to patient selection and inclusion. Pathologist Affiliation J. Meijer Rijnstate Hospital, Arnhem, The Netherlands J.E. van der Wal Martini Hospital, Groningen, The Netherlands L. Arensman Meander MC, Amersfoort, The Netherlands Tissue Bank, University Medical Center, Groningen, The Netherlands Stichting laboratorium Pathologie Oost-Nederland Publisher Copyright: © 2018 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC
(Peer reviewed)
