PRESENTATION AND CLINICAL OUTCOME OF PATIENTS WITH MALIGNANT SALIVARY GLAND TUMORS

Aim: Salivary gland cancer is a rare disease and comprises approximately 5 to 6 % of cancers of the head and neck and 0.3% of all cancers. These tumors display a diverse biological behaviors and clinical presentation. Currently, many series has described site, size stage, histology and grade of the tumors as important prognostic factors affecting the outcome. Aim of the work was to evaluate the presentation and management outcome of patients presented with salivary gland cancer in search of prognostic factors for locoregionl control, disease free survival, and overall survival. Methods: The records of all patients with malignant salivary gland tumors presenting for treatment at our institution between October 1997 and October 2002 were reviewed. Variables were collected and outcome measures were defined in terms of locoregional, and distant control, and overall survival and disease-free survival (DFS), in 5 years follow up. Survival was described using the Kaplan-Meier method. Results: This study included 46 patients (24 males and 22 females) ranging in age from 22 to 86 years with mean age of 53±18 years. The disease-free survival and overall survival rate were 65.5% and 69.5%, at 5 years, respectively. We found that survival was significantly better in younger patients (P = 0.05), male patients (P = 0.001) early stage ( P = 0.001), patients with parotid cancer (P = 0.004), low/intermediate grade (P = 0.0006) and patients who received postoperative adjuvant radiation (P = 0.003). Conclusions: The majority of our patients presented in advanced stage, which necessitated aggressive surgical treatment. Postoperative adjunctive radiotherapy seems to play an important role in those patients. However, the benefits of combined modality therapy await prospective clinical trials. This study confirmed the contributions of age, sex, site, stage, and grade for locoregional control and survival