The importance of clinical staging of minor salivary gland carcinoma

Article Abstract:

There are tremendous variations in the size, form, and presentation of tumors of the minor salivary glands (mucus-secreting, submucosal glands) of the head and neck. It has been reported that anatomic site and extent of tumor are the most significant prognostic indicators for survival. No staging system (a method for describing the extent of cancer and metastasis) currently exists for tumors of the minor salivary glands. To establish criteria for such a staging, a review was undertaken of patients with minor salivary gland cancer treated over a 45-year period. There were 459 patients with tumors of the minor salivary glands; 378 (78 percent) of these patients had cancer; and adequate data were available for 353 of these subjects. The average age of patients with cancer was 56 years, compared with 48 years for patients with benign tumors. The most common site for the tumor was the palate (37 percent), followed by the tongue (14 percent), and the cheek (10 percent). The criteria used to stage the cancer was similar to that used for squamous cell cancer of the same sites. For patients treated after 1966, survival was 75, 62, and 56 percent at 5, 10, and 15 years, respectively. This was a significant improvement over the survival rates of patients treated earlier. Survival was significantly influenced by clinical stage and tissue grade. Grading was limited to patients with mucoepidermoid cancer or adenocarcinoma. Using the staging system, the 10-year survival for stage I was 83 percent; stage II, 53 percent; stage III, 35 percent; and stage IV, 24 percent. Radiotherapy did not appear to improve survival. Patients with minor salivary gland cancer require surgical removal of all gross and microscopic cancer tissue. Patients with high-stage tumors, or those with surgical margins that are questionable may benefit from radiotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Tumor staging, Cancer staging, Mouth cancer, Mouth tumors

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Soft tissue sarcomas of the head and neck in adults

Article Abstract:

Sarcoma, cancer of the soft tissue that tends to be vascular and usually highly invasive, is frequently encountered as a painless swelling. Sarcomas of the head and neck represent less than 10 percent of all sarcomas. They carry a low survival rate for adults, although promising results have been achieved for children with the use of multi-agent chemotherapy. A review of 176 adult patients with head and neck sarcoma was undertaken in an attempt to identify factors that might predict prognosis and identify patients at high risk for non-response to treatment. These patients were treated between 1950 and 1985, and the minimum follow-up was two years. The average age was 48. Low-grade sarcoma was found in 72 patients (41 percent) and 104 patients had high-grade sarcoma. Surgical excision was the initial therapy for most patients; 18 patients had inoperable cancer. No significant benefit was obtained by the addition of radiotherapy or chemotherapy to the treatment regimen. Treatment failure was associated with large tumor size, excised tissue margins showing cancer, cancer involving the bone, local recurrence of disease, metastasis (spread outside the original site), and high histologic (tissue study) grade. The overall survival after two years was 75 percent; after five years, was 55 percent; and after 10 years, 46 percent. Patients who had high-grade sarcoma had 10-year survival of less than 20 percent, and only five patients who had high-grade metastatic sarcoma have survived (range 2 to 7 years). The histologic grade of sarcomas was a significant factor influencing overall survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Soft-tissue sarcomas of the head and neck

Article Abstract:

Soft-tissue sarcomas are tumors of connective tissue origin that usually metastasize (spread to distant parts of the body). The occurrence of these tumors in the head and neck region is relatively rare. The medical records of 352 patients who were diagnosed between 1962 and 1982 with soft-tissue sarcoma of the head and neck were reviewed to classify tumor type, site, treatment and survival rate. There were 194 males and 158 females whose ages ranged from six weeks to 91 years; 72 percent were adult patients and 28 percent were pediatric patients. The paranasal sinuses and neck were the most common sites of tumors. Surgery was the treatment used for 49 percent of the sarcomas. The survival rate in the group with desmoid and dermatofibrosarcoma protuberans tumors that did not metastasize (46 patients) was 100 percent over 10 years. Among the other patients, the survival rate for the 277 patients with localized nonmetastatic disease was 55 percent after 10 years, but the 29 patients with metastasis had a 10-year survival of 17 percent. Improvement in the treatment and management of soft-tissue sarcomas may be dependent on categorizing the diseases according to recurrence, metastasis and response to treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

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