Prognostic index for patients with parotid carcinoma

Abstract

BACKGROUNDValidation of the prognostic indices for the recurrence‐free interval of patients with parotid carcinoma, the development of which was described in a previous report, is needed to be confident of their generalizability and justified prospective use.METHODSThe Dutch Cooperative Group on Head and Neck Cancer database contains 231 patients with parotid carcinoma from six tertiary referral centers who were seen between 1985–1994. This database was used to validate the predictive value of the prognostic indices, PS1 (pretreatment index predicting recurrence) and PS2 (posttreatment index predicting recurrence), in patients with parotid carcinoma. Validation methods included calculation of both indices for each patient, comparison of coefficients, construction of survival curves using the published cutoff points, and calculation of concordance measure C. Wald tests for optimization of scale and weights of the contributing variables, and for possible score improvement by including other variables, were also performed.RESULTSThe 5‐year disease‐free rate was 62% (standard error = 4%). PS1 was calculated for 183 patients. The previously set cutoff points resulted in 5‐year disease‐free rates that ranged from 92% (PS1 = 1) to 42% for the least favorable group (PS1 = 4). Concordance measure C was 0.74. The postoperative score, PS2, was calculated for 171 patients. Previous cutoff points resulted in 5‐year disease‐free rates that ranged from 90% (PS2 = 1) to 40% (PS2 = 4). Concordance measure C was 0.71. Both PS1 and PS2 did not improve using the findings in this independent material.CONCLUSIONSThe prognostic indices performed adequately in this validation sample. This finding demonstrates that the prognosis of a parotid carcinoma patient can be quantified by using a weighted combination of the parameters of age, pain, clinical T (cT) classification, clinical N (cN) classification, skin invasion, facial nerve dysfunction, perineural growth, and involved surgical margins. A quantified prognosis, in terms of the recurrence‐free interval, can be used to provide information to the patient, to perform clinical trials, and eventually to make clinical decisions. A user‐friendly translation and computerized calculation of the indices should be the next step toward generalized prospective use and repetitive evaluation of the indices. Cancer 2003;97:1453–63. © 2003 American Cancer Society.DOI 10.1002/cncr.11254

Salivary acinic cell carcinoma: reappraisal and update

“…Previous inadequate treatment OS (36) RFS (36) DFS (13,35) OS (36) RFS (36) Additional radiotherapy (controversial findings) DSS worse (44) DSS better survival for high grade AcCC if additional radiotherapy (27) DFS better (36) DFS worse (44) OS overall survival, DSS disease specific survival, DFS disease free survival, LRC locoregional control, RFS recurrence free survival diagnosis [36]. With the exception of gender, these factors had already been identified and confirmed in other studies dealing with all types of SGCs [26,155,156]. Gender did not feature as a significant prognostic factor in the SEER analysis of Biron et al [44].…”

“…Unfortunately, the highly desirable population-based studies provide little information beyond incidence and survival [26][27][28]. Institution-based studies are more detailed, but report limited number (up to 35) of cases collected over a long period and treated without standardized protocols, which makes statistical evaluation difficult [29][30][31][32].…”

“…In western countries, salivary gland carcinomas (SGCs) account for about 4 % of all head and neck cancers, approximately 80 % occurring in the parotid [33]. About one out of six parotid cancers is AcCC [34], which is supported by a nationwide study in Netherlands, where 15 % of parotid malignancies were AcCC [26]. A recent surveillance, epidemiology, and end results (SEER) analysis from 1973 to 2009 indicated that AcCC comprises 11 % of all salivary gland malignancies, with an average annual incidence of 0.13 cases per 100,000 patients per year during the 36 years the study encompassed [28].…”

Salivary Gland Cancers: A Survey through History, Classifications and Managements

“…Acinic cell carcinoma (AcCC) comprises one of six parotid cancers which is supported by a nationwide study in the Netherlands where 15% of parotid malignancies were AcCC [21][22][23].…”

“…AdCC is mostly found in the parotid, submandibular and minor salivary glands. Based on previous studies, AdCC was the most frequent histology of parotid carcinoma [23]. In the submandibular gland, the likelihood of AdCC is even greater as it accounts for 40% of salivary gland cancers [75,76].…”