Salivary duct carcinoma: A clinopathological report of 11 cases

Abstract

Abstract. The aim of the present study was to summarize the clinicopathological and immunohistochemical characteristics of salivary duct carcinoma (SDC) and to evaluate the currently available treatment modalities. Between 2001 and 2011, 11 patients with SDC were diagnosed and treated at the Affiliated Hospital of Stomatology of Nanjing University (Nanjing, Jiangsu, China). The present study retrospectively reviewed the clinicopathological and immunohistochemical data of these 11 patients and the results indicated that the parotid gland was the most commonly affected site, followed by the submandibular gland and the palate. Furthermore, the mean age of onset was 58.8 years and all cases were treated with surgery, with 72.7% receiving post-operative radiation therapy. The range for the follow-up period was 10-89 months and of the 11 patients investigated, only two succumbed to the disease. In addition, the two-year overall survival rate was 75% according to Kaplan-Meier analysis and the mean overall survival time was 72.8 months. In conclusion, the present study determined that the site of the malignancy is the best predictor of survival in patients with the rare salivary malignancy SDC, while age, gender, T stage, N stage, American Joint Committee on Cancer stage, nerve paralysis, post-operative radiation, neck dissection, and protein expression levels of Ki-67, androgen receptor and human epidermal growth factor-2/neu are less influential factors. IntroductionSalivary duct carcinoma (SDC) is a rare type of salivary malignancy which accounts for <10% of all salivary malignancies, and the majority of its histological characteristics are similar to those of mammary duct carcinoma (1-3). SDC exhibits characteristic ductal lesions and tumor cells are often arranged in a 'Roman bridge' formation and cribriform architecture, with comedo necrosis (2). Due to the rarity of SDC, little data regarding its clinicopathological characteristics exists. The standard treatment for SDC is surgery in combination with radiotherapy, however, the prognosis of SDC is poor (4-7). Effective therapeutic strategies rely on a sufficient understanding of SDC and its prognostic factors, therefore, the aim of the present retrospective study was to summarize the clinicopathological characteristics of SDC and to evaluate the current treatment modalities currently used at the Affiliated Hospital of Stomatology of Nanjing University (Nanjing, Jiangsu, China). (2), were identified at the Affiliated Hospital of Stomatology. Subsequent to excluding any patients with distant metastasis or a previous history of head-neck surgery, all 11 patients primarily underwent surgical treatment, predominantly consisting of local extensive resection with neck dissection, followed by post-operative radiation therapy. All cases were followed up from the date of the surgical procedure to the date of mortality or the date patients were lost to follow-up. Clinical and histological data were reviewed (Table I). Patients and methods PatientsStatistical analysis. All d...

Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy

“…SDC is most frequently seen in men aged 50 or older [4, 6, 16, 18, 19] and is one of the more rare malignant salivary tumors. In one series of all salivary gland cancers during a 5-year period in Finland, it was estimated that 4–6% were SDC [20].…”

“…T3 or T4), with figures ranging from 35–74% [2, 4–7, 9, 11, 12, 14, 15, 18, 22, 31–38]. Two separate National Cancer Data Base (NCDB) studies, each with over 400 patients, found that 40–42% of patients presented with advanced T stage [36, 38].…”

“…The risk of pathologic N+ disease ranges from 47–83% in the literature [2, 4–10, 12, 14–16, 18, 19, 22, 31–40]. However, analyses using national databases or multiple institutions described an N+ incidence of 47–56% [2, 19, 35–38].…”

“…Perineural invasion (PNI) and lymphovascular invasion (LVI) are noted in 28–85% [2, 5–8, 11, 12, 14, 18, 31, 32, 40] and 20–71% [2, 5–8, 11, 12, 14, 31, 32, 40] of patients, respectively. The largest single institution study of SDC was conducted at the University of Pittsburgh Medical Center and described the incidence of PNI and LVI as 69% and 61%, respectively [7].…”

“…Facial nerve resection is often required (40–73%) to achieve oncologically sound resection of the primary site [5, 7, 9, 10, 18]. …”