Salivary Gland Tumors Research Articles

The importance of molecular testing in salivary gland tumour diagnosis: a case report

The importance of molecular testing in salivary gland tumour diagnosis: a case report

Usage of Milan System in Risk Stratification of Submandibular Gland Fine Needle Aspiration Cytology.

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) categorizes fine needle aspiration and cytology (FNAC) results into 6 tiers and assigns a risk of malignancy (ROM) to each category. Its utility in submandibular gland lesions remains unclear. Our article aims to study (1) the utility of the MSRSGC in classifying FNAC of submandibular gland masses, (2) describe the demographics and incidence of submandibular gland malignancy in our population, and (3) analyze the accuracy of FNAC in diagnosis of benign and malignant submandibular gland tumors. In this retrospective case series, the FNAC results of 92 patients who underwent pre-operative FNAC and excision of submandibular gland between May 2008 and December 2023 were reviewed and assigned to a MSRSGC category, and ROM was calculated based on histological diagnosis. 20/92 (21.7%) submandibular gland excisions with pre-operative FNAC were malignant. ROM is as follows: non-diagnostic 7.1%, non-neoplastic 12.5%, atypia of undetermined significance 35.3%, benign neoplasm 3.3%, salivary gland neoplasm of uncertain malignant potential 35%, suspicious for malignancy 100%, and malignant 100%. Our study validates the usage of the MSRSGC in the work up of submandibular gland tumors. 4 Laryngoscope, 2025.

The Trend in Age-Adjusted Incidence of Head and Neck Cancer in South Korea over the Past 20 Years.

We aimed to calculate the age-adjusted incidence rate of head and neck cancer (HNC) in South Korea from 1999 to 2020 and investigate the incidence trend of HNC excluding the effect of population aging. Data were obtained from the Cancer Registration Statistics Program. All 12 types of HNCs were analyzed. For each HNC type, the crude incidence rate and number of new cases during 1999-2020 are presented according to sex and age group. Age-adjusted incidence rates were calculated based on the World Standard Population (WHO 2000-2025), and its trends were also measured. Although the crude incidence rates of all HNCs have been steadily increasing from 1999 to 2020, the absolute values were very low in most cases, less than 2/100,000. The male-to-female ratio was 1 or higher for all HNCs except thyroid cancer, and 10 or higher for laryngeal cancer and hypopharyngeal cancer. The trend of age-adjusted incidence was a gradual increase for tongue cancer, tonsil cancer, major salivary gland cancer, and thyroid cancer, a decrease for laryngeal cancer, and no significant change for the remaining HNCs. Excluding the population aging effect, tongue cancer, tonsil cancer, major salivary gland cancer, and thyroid cancer among HNCs have been increasing in South Korea over the past 20 years, while laryngeal cancer has been decreasing.

Management of Clinically Node-Negative Salivary Gland Cancer: Observation, Neck Dissection, or Neck Irradiation?

Salivary gland malignancies are heterogeneous tumors with highly variable outcomes. Elective neck management options include observation, neck dissection (ND), and neck irradiation (NI). We sought to compare outcomes of cN0 salivary gland cancer by elective neck management. An IRB-approved registry was queried for cN0 salivary gland cancers and categorized based on neck management into observation, ND, NI, and ND + NI groups. cN0 included no evidence of clinical or radiographic metastatic lymphadenopathy. A total of 445 patients were included with 203 in observation, 83 ND, 71 NI, and 88 ND + NI. Median follow-up was 60.8 months (range 0.4-258). There were 47% clinical T1 tumors, 29% T2, and 12% of each T3 and T4. Exactly 90% were cN0 and 10% with borderline lymph node(s). The major salivary gland was the most common site (74%) and the most common histologies included 28% mucoepidermoid and 20% adenoid cystic. Risk factors associated with regional recurrence include age, borderline lymph node features, pathologic T and N stage, poorly differentiated, positive margin, lymphovascular space invasion, and extranodal extension (all p < 0.05). There was no significant difference in local (9.9%-16.7%, p = 0.6) or regional (3.9%-9.4%, p = 0.76) recurrence between all four groups. Five-year distant recurrence was significantly different at 7% for observation, 16% in ND, 25% in NI, and 37% in ND + NI (p < 0.001). Ten-year OS estimates were 78% for observation, 66% for ND, 69% for NI, and 52% in ND + NI (p < 0.001). For patients with cN0 salivary gland cancer, ND and NI yield similar regional control in appropriately selected patients. In high-risk patients with several adverse risk features ND + NI results in favorable regional control but distant metastasis is a driving factor affecting overall survival.

Atypical and worrisome histological features in pleomorphic adenoma: challenging and potentially significant diagnostic pitfall.

Pleomorphic adenoma (PA), the most prevalent salivary gland tumor, exhibits a diverse histological spectrum characterized by epithelial, myoepithelial, and mesenchymal patterns, and secretory products. However, a subset of PAs presents microscopic features suggestive of malignancy, leading to challenging and potentially significant diagnostic pitfalls. A comprehensive retrospective analysis was conducted on the Salivary Gland Tumor Registry, compiled by the authors. A total of 104 cases diagnosed between 1960 and 2023 were retrieved. Clinical findings, pathological features, and molecular genetic results were analyzed. In the study of 104 PA cases, 23 (22.1%) presented features suggestive of pseudoinvasion, with satellite nodules being the most common (43.5%) along with capsular penetration, irregular growth, pseudopodia, lipomatous changes, and vascular permeation. Features of pseudomalignant cytomorphology were found in 97 cases (93.3%), characterized by increased cellularity, cellular atypia, heightened proliferative activity, oncocytic metaplasia, and necrosis. Additionally, 30 cases (28.8%) displayed features resembling other defined malignant salivary gland tumors, particularly myoepithelial carcinoma, adenoid cystic carcinoma, and polymorphous adenocarcinoma. Despite PA's generally straightforward diagnosis, cases with these features may be mistakenly interpreted as malignant tumors. The shared morphocytological features underscore the complexity of anaccurate diagnosis, emphasizing the need for meticulous examination and a comprehensive assessment, incorporating morphological, molecular, and immunohistochemical analyses to differentiate between benign and malignant salivary gland tumors, in selected cases.

Aurora kinase A expression in pleomorphic adenoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma of salivary glands: an immunohistochemical study

BackgroundAurora kinase A (AurkA) plays a vital role in mitosis and is therefore critical in tumors development and progression. There are a few studies on AurkA expression in salivary gland tumors. The aim of the present study was to evaluate the expression pattern of AurkA in the most common benign and malignant salivary gland tumors by immunohistochemistry.MethodsIn this retrospective cross-sectional study, 68 cases including 25 pleomorphic adenomas (PAs), 21 adenoid cystic carcinomas (ADCa), 15 mucoepidermoid carcinomas (MEC), and 7 normal salivary glands (NSG) were enrolled from the archive of the Department of Pathology of Shiraz School of Dentistry, Iran. The expression of AurkA in the tissue samples was assessed by immunohistochemical method and was analyzed using statistical analysis (p < 0.05).ResultsOf total cases analyzed, the majority of benign and malignant tumors were found to involve minor salivary glands compared to major salivary glands (p < 0.001). In addition, all lesions studied expressed AurkA. More than half of the tumor tissues showed AurkA staining percentages between 26 and 50% and 76–100% compared to NSG (p = 0.08). In 44.1% of cases, cells had a weak staining score, 27.9% a moderate score and the rest (27.9%) a strong score (p = 0.64).ConclusionAlthough AurkA was observed to be expressed in all tumor tissues, further studies are needed to clearly understand the role of AurkA and the possibility of using it as a diagnostic, prognostic and therapeutic factor.

Sonography of Salivary Gland Tumors and Disorders.

Diseases of the salivary glands are as common as they are diverse and can have different causes. Clinicians can differentiate salivary gland changes based on chronic systemic diseases, congenital and vascular malformations, and benign and malignant tumors. Acute infectious pathologies can also arise as a result of obstructive pathologies. A large number of diseases with similar clinical presentations have to be differentiated. Due to the improved resolution of ultrasound technology over the last 20 years, it is now used as the first imaging modality to examine salivary gland pathologies. It allows a quick, dynamic, and non-invasive examination of the salivary glands and the soft tissue of the neck. In order to accurately diagnose and treat patients, a very good knowledge of these diseases and their appearance on sonography is required.

18F-FDG PET/CT for Surveillance in Salivary Gland Cancers: A Systematic Review and Meta-Analysis.

To evaluate the diagnostic accuracy of 18F-FDG-PET/CT compared to conventional imaging modalities (CIM) to detect recurrence of primary salivary gland cancers (SGCs). Review performed on December 26, 2024, using Embase, CINHAL, MEDLINE, and PubMed. Two blinded reviewers selected studies reporting diagnostic accuracy of PET/CT in identifying locoregional recurrence and/or metastasis in patients with SGCs. The analysis was performed adhering to PRISMA guidelines using R 4.3.3. Pooled analysis with 95% confidence intervals (CI) were analyzed. A total of 12 studies were retained from the systematic review, including 264 patients evaluated in the meta-analysis. For local recurrence, there was a pooled sensitivity of 0.86 (95% CI 0.73-0.93) and a pooled specificity of 0.95 (95% CI 0.92-0.97) for PET/CT, and a pooled sensitivity of 0.89 (95% CI 0.80-0.94) and a pooled specificity of 0.91 (95% CI 0.79-0.97) for CIM (p = 0.90). For regional metastasis, there was a pooled sensitivity of 0.90 (95% CI 0.73-0.97) and a pooled specificity of 0.96 (95% CI 0.92-0.98) for PET/CT, and a pooled sensitivity of 0.80 (95% CI 0.62-0.91) and a pooled specificity of 0.95 (0.90-0.98) for CIM (p = 0.26). For distant metastasis, there was a pooled sensitivity of 0.96 (95% CI 0.90-0.99) and a pooled specificity of 0.95 (95% CI 0.85-0.98) for PET/CT, and a pooled sensitivity of 0.80 (95% CI 0.71-0.86) and a pooled specificity of 0.97 (95% CI 0.87-0.99) for CIM (p = 0.018). 18F-FDG-PET/CT imaging is accurate for the detection of SGC recurrence, particularly for the detection of regional and distant metastases. Not applicable Laryngoscope, 2025.

Effects of intra-tumoral cellular heterogeneity of oxygen partial pressure on biological effectiveness of hydrogen-, helium-, carbon-, oxygen-, and neon-ion beams

Objective.The tumor microenvironment characterized by heterogeneously organized vasculatures causes intra-tumoral heterogeneity of oxygen partial pressurepat the cellular level, which cannot be measured by current imaging techniques. The intra-tumoral cellularpheterogeneity may lead to a reduction of therapeutic effects of radiation. The purpose of this study was to investigate the effects of the heterogeneity on biological effectiveness of H-, He-, C-, O-, and Ne-ion beams for different oxygenation levels, prescribed dose levels, and cell types.Approach.The intra-tumoral cellularpdistributions were simulated with a numerical tumor model for average oxygen pressuresp¯tranging from 2.5 to 15 mmHg. The relative biological effectiveness (RBE)-weighted dose distributions of 3-15 Gy prescribed doses were planned for a cuboid target with the five ion species for constantp¯tvalues. Radiosensitivities of human salivary gland tumor (HSG) and Chinese hamster ovary (CHO) cells were investigated. The planned dose distributions were then recalculated by taking thepheterogeneity into account.Main results.Asp¯tdecreased and prescribed dose increased, the biological effectiveness of the ion beams decreased due to thepheterogeneity. The reduction in biological effectiveness was pronounced for lighter H- and He-ion beams compared to heavier C-, O-, and Ne-ion beams. The RBE-weighted dose in the target for HSG (CHO) cells decreased by 41.2% (44.3%) for the H-ion beam, while it decreased by 16.7% (14.7%) for the Ne-ion beam at a prescribed dose of 15 Gy under ap¯tof 2.5 mmHg.Significance.The intra-tumoral cellularpheterogeneity causes a significant reduction in biological effectiveness of ion beams. These effects should be considered in estimation of therapeutic outcomes.

Cytological features of oncocytic pleomorphic adenoma of the salivary gland: Using the Milan classification system to report 3 patients.

Pleomorphic adenoma (PA) is the most common salivary gland tumour. Pre-operative fine-needle aspiration (FNA) is currently one of the most widely used cytological examination techniques for the diagnosis of salivary gland tumours. Because PA exhibits characteristic cytological features, cytological diagnosis is straightforward in most cases. However, limitations have emerged in certain cases, specifically in cases of oncocytic metaplasia (rare in PA), characterised by rich eosinophilic granular cytoplasm and relatively large nuclei, which can make cytological diagnosis challenging. To date, only two cytological reports of oncocytic PA have been published. The present study retrospectively analysed patients with oncocytic PA of the salivary gland who underwent preoperative FNA to describe the clinicopathological features of oncocytic PA. In addition, the application of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was discussed. The study cohort included 3 patients with parotid gland tumours. The cytological specimens had small and/or large clusters of oncocytic cells containing rich granular cytoplasm, relatively large nuclei, and occasional nucleoli in a myxoid (2 patients) and clear (1 patient) background, with no necrotic material. A review of the cytological features of the presented cases, as well as previously reported cases, indicated that oncocytic PA may be overdiagnosed as carcinoma, especially carcinoma ex pleomorphic adenoma (CXPA) because these cells have relatively large nuclei. The cytological features of oncocytic cells in PA resemble those of salivary duct carcinoma, the most common carcinoma component of CXPA. The absence of necrotic material and high-grade nuclear atypia are important diagnostic features. Furthermore, cytological specimens with atypical oncocytic cells in the PA should be classified as salivary neoplasms in the uncertain malignant potential category of the MSRSGC.

Molecular profile of salivary gland tumors: discovering new targets for therapy

Introduction. Due to variety of morphological subtypes and poor clinical response, comprehensive molecular profiling for salivary gland cancers become a part of treatment strategy for chemotherapy-resistant cases. Tumors of the salivary glands include more than 20 histological types distinguished by their biological characteristics, response to therapy, and prognosis. The search for specific therapeutically significant markers and mutations for various histological types of salivary gland tumors may allow the development of a diagnostic algorithm and improve patient treatment results.Aim. To search for therapeutically significant molecular and genetic targets and immunohistochemical markers in various histological types of malignant salivary gland tumors.Materials and methods. We analyzed data on 280 patients with unresectable recurrent and metastatic salivary gland cancer to identify the main characteristic therapeutically significant immunohistochemical (androgen receptor (AR), epidermal growth factor receptor type 2 (HER2neu), epidermal growth factor receptor (EgfR), programmed cell death receptor 1 (pD-L1) (CpS), сD117, estrogen receptor (ER), progesterone receptor (pR), pan-TRk) and molecular genetic targets (ALK, BRAF, ERBB2, KIT, MET, RET, ROS1, SMO, AR, HRAS, PIK3CA, PDGFRA, NTRK1-3) depending on the histological subtype of the tumor.Results. Based on the results obtained, in comparison with previous studies, a greater diversity of therapeutically significant mutations, fusions and immunohistochemical markers was revealed for various histological types of tumors. Interestingly, increased expression of AR was detected not only in salivary duct carcinoma, but also in carcinoma ex pleomorphic adenoma, adenocarcinoma not otherwise specified, myoepithelial, mucoepidermoid, adenoid cystic, acinic cell, polymorphous adenocarcinomas. ETV6-NTRK3 gene fusions in addition to secretory carcinoma were detected in mucoepidermoid and salivary duct carcinomas. mutations and fusions in the RET gene have been identified in ductal and mucoepidermoid carcinomas, as well as adenocarcinoma not otherwise specified.Conclusion. The results of the study allow to expand the group of patients for molecular genetic and IHC testing in order to individualize therapy.

Retrospective Clinicopathological Study of 33 Cases of Pleomorphic Salivary Adenoma Diagnosed in Benghazi

Background: Pleomorphic salivary adenoma (PSA) is the most frequently found neoplastic tumor in major and minor salivary glands. It has a high recurrence rate and there is a possibility for benign PSA to transform into malignant form. No study on clinical and histopathological features of pleomorphic adenoma in Libya was found. occurrence of benign PSA is more common than PSA with malignant foci. Aim: The present study aimed to retrospectively analyze the clinical and histopathological features of cases diagnosed as pleomorphic adenoma and compare our findings to those of other studies. Materials and Methods: In this retrospective study, the pleomorphic salivary adenoma cases diagnosed between 1994-2019 in the Department of Oral Pathology, Dental School, University of Benghazi, Libya were retrieved. The diagnosis was confirmed by reevaluation of hematoxylin and eosin-stained slides. Descriptive statistics were used to describe the clinical data of the patient’s demographics and clinical features of the tumor. Results: It was found that among 33 diagnosed cases of PSA, 11 cases were males and 22 cases were females. The most common age range was 10-29 years (21 cases). The most common intra-oral site was the palate (15 cases) followed by buccal mucosa (6 cases) and submandibular glands and parotid glands were most commonly affected among major salivary glands. Benign pleomorphic adenoma (24 cases) was most common, myoepithelium was reported in 2 cases and malignant foci were reported in 7 cases. Conclusion: This study revealed that Females were more affected than males. The most common location of pleomorphic adenoma was the palate. The myoepithelioma is a rare.

Surgical management of benign tumors of the parotid gland: the advantages of extracapsular dissection compared to traditional surgical techniques.

Salivary gland tumors represent only 3%-6% of all head and neck neoplasms, and approximately 70% of these tumors are located in the parotid gland. Most of these tumors are found in the more abundant superficial portion of the parotid gland, lateral to the facial nerve (FN). For many years, the location of the facial nerve between the superficial and deep segments of the parotid gland hindered adequate tumor extirpation. Several surgical options are available for the treatment of benign tumors in the parotid gland, but there remains no universal agreement on what the optimal surgical treatment is. In the early twentieth century, tumor enucleation was the standard treatment for parotid tumors to preserve the facial nerve, but high recurrence rates were the main downside of this procedure. To improve the outcome, superficial parotidectomy (SP) was implemented, which involves excision of the entire lateral segment of the parotid gland, superficial to the facial nerve. However, this surgical procedure may lead to severe postoperative complications, including facial nerve paralysis, in a significant number of patients. In recent years, more gland-preserving techniques were developed to reduce complication rates and improve the safety of procedures and patients' satisfaction, without increasing the risk of recurrence. This study compares our surgical experience with extracapsular dissection gland-sparing surgery (ECD) to traditional superficial parotidectomy in 56 patients who underwent surgery performed by the same surgical team. The superiority of ECD procedures compared to SP procedures was shown as far as total complication rates are concerned. In this case, Fisher's exact test statistic value was 0.0043 (significant at P < 0.05). ECD should be applied in properly selected cases and further prospective studies are needed to clarify the optimal indications.

Epidemiological trends in head and neck cancer in Nara Prefecture, Japan, from 2000-2021: The impact of the COVID-19 pandemic.

Epidemiological surveys were conducted in Nara Prefecture, Japan, to determine the prevalence of head and neck cancer in the region since 1986. This study examined the dynamics of visits to 18 medical institutions treating head and neck cancer in Nara Prefecture from 2000 to 2021. A total of 8,605 patients were registered, with 4,788 being male and 3,787 female. These included 3,603 thyroid, 2,215 oral, 1,164 laryngeal, 645 hypopharyngeal, 512 oropharyngeal, 326 nasal sinus, and 286 salivary gland cancer cases. A marked increase in subsite was observed in oropharyngeal, oral, and hypopharyngeal cancers, whereas laryngeal cancer remained unchanged. The number of registered patients increased every year, with 547 new patients registered in 2019, compared to 249 in 2000. However, the number of registered cases decreased by nearly 100 cases after 2020 because of the COVID-19 pandemic (453 cases in 2020 and 420 cases in 2021). This study is distinctive as it comprehensively surveys all departments within Nara Prefecture involved in managing head and neck cancer.

A phase Ia study of a novel anti-HER2 antibody–drug conjugate GQ1001 in patients with previously treated HER2 positive advanced solid tumors

BackgroundA novel anti-human epidermal growth factor receptor 2 (HER2) antibody–drug conjugate (ADC) GQ1001 was assessed in patients with previously treated HER2 positive advanced solid tumors in a global multi-center phase Ia dose escalation trial.MethodsIn this phase Ia trial, a modified 3 + 3 study design was adopted during dose escalation phase. Eligible patients were enrolled, and GQ1001 monotherapy was administered intravenously every 3 weeks. The starting dose was 1.2 mg/kg, followed by 2.4, 3.6, 4.8, 6.0, 7.2 and 8.4 mg/kg. Extra patients were enrolled into 6.0, 7.2, and 8.4 mg/kg cohorts as dose expansion phase. The primary endpoints were safety and to determine the maximum tolerated dose (MTD) based on dose limiting toxicities (DLTs). Pharmacokinetics and anti-tumor efficacy of GQ1001 were assessed. The plasma concentration of free DM1, the payload of GQ1001, was quantitated.ResultsA total of 32 patients were enrolled, predominantly in breast (9), gastric or gastro-esophageal junction (9) and salivary gland cancer (4). Median number of prior-line of therapies was 3 (0–11) and 37.5% patients received ≥ 2 lines of anti-HER2 therapies. No DLT was observed during dose escalation. MTD was not reached and dose recommended for dose expansion (DRDE) was determined as 8.4 mg/kg. Grade ≥ 3 treatment-related adverse events rate was 28.1% (9/32) and platelet count decreased (4/32, 12.5%) was the most common one. No drug-related death was observed. Objective response rate and disease control rate of 15 evaluable patients in 7.2 mg/kg and 8.4 mg/kg cohorts were 40.0% (6/15) and 60.0% (9/15). Pharmacokinetics analysis showed low exposure and accumulation of free DM1 in circulation.ConclusionGQ1001 is well tolerated and shows promising efficacy in previously treated HER2-positive advanced solid tumors. DRDE was determined as 8.4 mg/kg for following trials.Trial registration NCT, NCT04450732, Registered 23 June 2020, https://clinicaltrials.gov/study/NCT04450732

Treatment outcomes of primary salivary gland squamous cell carcinoma: A multi-institutional retrospective study in Japan.

Primary salivary gland squamous cell carcinoma (SCC) is extremely rare, accounting for 0.3-10.4 % of all salivary gland malignancies. Due to this rarity, the clinical characteristics of primary salivary gland SCC remain unelucidated. In the present study, we conducted a multi-institutional retrospective analysis-including a large number of cases compared with that of previous studies-to reveal the prognosis, treatment outcomes, and prognostic factors of primary salivary gland SCC. The clinical course of patients with primary salivary gland SCC between January 2012 and December 2022 was retrospectively investigated. Thirteen university hospitals and cancer centers in Japan participated in this study. The diagnosis of primary salivary gland SCC was based on the following criteria: 1) pathological diagnosis of SCC and exclusion of other histological types and 2) exclusion of metastatic SCCs from other organs. Progression-free and overall survival rates were compared using Kaplan-Meier curves and log-rank tests. Treatment outcomes were assessed using univariate and multivariate analyses with Cox proportional hazards models. In total, 723 patients with salivary gland cancer were admitted to the participating institutions. Among them, 63 patients (8.7 %) were diagnosed with primary salivary gland SCC. The clinical courses of the 58 patients that received definitive treatment and had complete data were analyzed. Primary treatments included surgery in 35 patients (60.3 %), chemoradiotherapy in 16 (27.6 %), radiotherapy in 5 (8.6 %), and chemotherapy in 2 (3.4 %). Complete response and objective response rates to chemoradiotherapy were 62.5 % and 93.8 %, respectively. Five-year progression-free and overall survival rates were 30.1 % and 60.1 %, respectively. Five-year progression-free survival rates for each treatment were 37.7 % (surgery), 33.0 % (chemoradiotherapy), 0 % (radiotherapy), and 0 % (chemotherapy). Overall survival rates were 71.5 % (surgery), 39.5 % (chemoradiotherapy), 53.3 % (radiotherapy), and 0 % (chemotherapy). Multivariate analysis revealed that age ≥70 years, N classification ≥1, and surgery were independent predictors of progression-free (hazard ratios: 3.75, 2.46, and 0.33, respectively) and overall survival (hazard ratios: 3.11, 6.24, and 0.32, respectively). Adjuvant radiotherapy significantly improved progression-free and overall survival in patients with stage Ⅳ cancer or positive surgical margins. Log-rank tests revealed no significant difference between patients with or without elective neck dissection in progression-free and overall survival; however, a relatively high percentage of occult lymph node metastasis (50.0 %) was observed. Surgical resection is a favorable first-line treatment option in salivary gland SCC, and definitive chemoradiotherapy would show acceptable complete and objective response rates.

Survival benefit of cancer-directed surgery and the role of adjuvant therapy in malignant major salivary gland cancers: a propensity score matched retrospective analysis.

The primary objective of this study was to assess the benefit of cancer-directed surgery (CDS) on both overall survival (OS) and cancer-specific survival (CSS) of patients with malignant major salivary gland cancers (MMSGCs). The secondary objective was to explore the benefits of adjuvant therapy on the survival outcomes of these patients. Patients diagnosed with MMSGC were extracted from the SEER database and subsequently categorized into two cohorts: CDS and non-CDS. Propensity score matching (PSM) was used to mitigate confounding variables. The survival benefit associated with CDS was evaluated using Kaplan-Meier analysis, log-rank tests, and Cox proportional hazard models. Furthermore, the impact of adjuvant radiotherapy and chemotherapy was explored within the CDS subgroup. A total of 7,029 patients with MMSGC were included. PSM was performed and resulted in a matched cohort between both groups, including 595 patients in each group. Multivariable Cox proportional hazard indicated that patients who received CDS had better OS (HR: 0.45, 95% CI [0.39 to 0.52], P < 0.001) and CSS (HR: 0.46, 95% CI [0.40 to 0.52], P < 0.001). The 5- and 10-year OS for the CDS group was 42% (95% CI, 38 - 46%), and 25% (95% CI, 21 - 29%) consecutively, while the 5- and 10-year OS for the non-CDS group was 20% (95% CI, 17 - 24%), and 12% (95% CI, 9.7 - 16%) consecutively. Moreover, patients with younger age, localized tumors, and lower TNM stage could benefit more from CDS. Radiotherapy as adjuvant therapy was found to be beneficial (HR: 0.69, 95% CI [0.55-0.85], p < 0.001), while chemotherapy could not significantly benefit these patients. CDS improved the OS and CSS survival in MMSGC patients. Specific patient subgroups seemed to have a superior benefit from CDS. Adjuvant radiotherapy could help enhance the survival outcomes of these patients while chemotherapy could not.

Predictors of recurrence and survival after salivary gland cancer surgery: A multicenter, retrospective study in northern Japan

ObjectivesSalivary gland cancer is a rare disease composed of more than 20 histological types with different grades of malignancy. The aim of this multicenter, retrospective study was to identify the most important predictors affecting recurrence and survival after surgery. Material and MethodsA total of 543 patients with salivary gland cancers that underwent curative surgery between 2012 and 2022 in 13 institutions in northern Japan were evaluated in this study. Predictors affecting recurrence and survival were identified by univariate and multivariate Cox regression analyses. Age, sex, primary site, histological type, pathological T status, surgical margin, lymph node metastasis, extranodal extension, and postoperative radiotherapy were the variables evaluated. ResultsMultivariate Cox regression analysis showed that increasing age, submandibular cancer, pathological T status 3 or 4, positive surgical margin, and lymph node metastasis, especially with extranodal extension, were independent risk factors for both recurrence and survival. Sublingual cancer was an independent risk factor for recurrence. Postoperative radiotherapy was associated with a lower risk of recurrence and a good prognosis, and adenoid cystic carcinoma was associated with a good prognosis. ConclusionLymph node metastasis with extranodal extension was the most important prognostic factor affecting both recurrence and survival after surgery, adenoid cystic carcinoma was associated with a good prognosis, and postoperative radiotherapy was associated with a lower risk of recurrence and a good prognosis.

Bilateral Orocutaneous Fistula Secondary to Pericoronal Infection of Mandibular Third Molars: A Rare Case Report.

Odontogenic cutaneous fistulas are abnormal connections between the oral cavity and skin, often mistaken for skin infections. They typically result from dental infections but may also arise from salivary gland issues, tumors, or congenital anomalies. Accurate diagnosis is essential to prevent complications like infection, osteomyelitis, and discomfort. A 26-year-old woman presented with bilateral facial lesions and itching for the past year. Her symptoms began 5 years earlier with cheek pain and swelling, initially treated with antibiotics. Examination revealed pericoronitis of the mandibular third molars, leading to bilateral orocutaneous fistulas. Surgical removal of the affected teeth and fistulas was performed. Orocutaneous fistulas commonly result from long-standing dental infections. Their location depends on the perforation site of the cortical plate. Early diagnosis through clinical examination and imaging is vital to prevent severe complications like osteomyelitis. Treatment involves addressing the underlying cause, typically through root canal therapy or tooth extraction. This case highlights the importance of early, interdisciplinary management of orocutaneous fistulas to prevent misdiagnosis, reduce discomfort, and avoid complications. Timely treatment ensures better outcomes and minimizes cosmetic concerns.

UNet-driven image segmentation for improved salivary gland tumor detection

UNet-driven image segmentation for improved salivary gland tumor detection