Incompletely treated malignancies of the major salivary gland: Toward evidence-based care

Head Neck. 2018 Aug;40(8):1630-1638. doi: 10.1002/hed.25156. Epub 2018 May 7.


Background: Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment-related outcomes for patients with incompletely treated major salivary gland tumors.

Methods: A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure.

Results: Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P < .001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HRadjusted ] 2.55; 95% confidence interval [CI] 1.20-5.30; metastatic disease HRadjusted 9.53; 95% CI 3.04-27.06).

Conclusion: Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival.

Keywords: adjuvant chemotherapy; adjuvant radiotherapy; healthcare delivery; reoperation; salivary gland neoplasms.

MeSH terms

  • Age Factors
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / therapy
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Metastasis*
  • Neoplasm, Residual / mortality*
  • Neoplasm, Residual / therapy
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Salivary Gland Neoplasms / mortality*
  • Salivary Gland Neoplasms / pathology
  • Salivary Gland Neoplasms / therapy*
  • Time-to-Treatment
  • Tumor Burden