TY - JOUR
T1 - A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands
AU - Boon, E.
AU - Bel, M.
AU - van Boxtel, W.
AU - van der Graaf, W.T.A.
AU - van Es, R.J.J.
AU - Eerenstein, S.E.J.
AU - Baatenburg de Jong, R.J.
AU - van den Brekel, M.W.M.
AU - van der Velden, L.-A.
AU - Witjes, M.J.H.
AU - Hoeben, A.
AU - Willems, S.M.
AU - Bloemena, E.
AU - Smit, L.A.
AU - Oosting, S.F.
AU - PALGA Group
AU - Jonker, M.A.
AU - Flucke, U.E.
AU - van Herpen, C.M.L.
PY - 2018/8/15
Y1 - 2018/8/15
N2 - 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. 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.
AB - 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. 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.
KW - ErbB-2
KW - androgen receptors
KW - fluorescence
KW - immunohistochemistry
KW - in situ hybridization
KW - prognosis
KW - receptor
KW - salivary duct carcinoma
KW - salivary gland neoplasms
KW - survival
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85044181718&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29492965
UR - http://www.scopus.com/inward/record.url?scp=85044181718&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ijc.31353
DO - https://doi.org/10.1002/ijc.31353
M3 - Article
C2 - 29492965
SN - 0020-7136
VL - 143
SP - 758
EP - 766
JO - International journal of cancer
JF - International journal of cancer
IS - 4
ER -