Salivary Gland Tumor: Clinical Analysis Of 1207 Cases

Objective To discuss the clinical features of salivary gland tumor.Methods Review and compare the patients with salivary gland tumor managed with primary surgery,between January 1998 and December 2007, using the clinical data from the Department of head & neck surgery in Cancer hospital of Fudan University,Shanghai,China,build a database of salivary gland tumor.The comparison of clinical features were analysed, where relevant,by univariate and multivariate models.SPSS version 16.0 (SPSS Inc) software was used in the data analysis.Results are summarized by P values and those less than significance level 0.05 are considered statistically significant.Results There were totally 1207 cases of salivary gland tumor,with 598 male cases,female 609.Patient age range for 8 years to 86,with an average age of 46.6 years.Tumor sites were the parotid gland in 903 cases, submandibular in 261 cases,sublingual 6 cases,small salivary gland 37 cases.The ratio of benign to malignant is 3:1,with 917 benign cases and 290 malignant.Benign tumors were consisted of 619 cases of pleomorphic adenoma,207 cases of Warthin tumor and 77 other cases.In malignant tumor, 71 cases of mucoepidermoid carcinoma,53 cases of adenoid cystic carcinoma and 37 cases of acinic cell carcinoma were accounted for the most frequent pattern,others 129 cases.The follow up rate was 86.36% (152/176),with the mean time on 40.03 months(range from 2 months to 143 months),median time on 28 months.The overall 5- and 10- year survival rates of the 176 patients of parotid gland carcinoma was 83%and 67%.Univariate survival analysis showed that five factors were prognostic factors of parotid gland carcinoma,such as sex,lymph node metastasis, distant metastasis and pathology grade and pathology stage.Multivariate survival analysis revealed that lymph node metastasis(P<0.001),distant metastasis(P<0.001) and pathology grade(P=0.011) were independent prognostic factors.Conclusion The site of salivary gland tumor varied extensively,mostly occured in salivary gland and submandibular gland,with no distinct distinguishing between the sexes.The ratio of benign to malignant is 3:1.The pathologic types of salivary gland tumors were complex.Pleomorphic adenoma and Warthin tumor were the most frequent benign tumors.The majority of malignant tumor were mucoepidermoid carcinoma,adenoid cystic carcinoma and acinic cell carcinoma,and moreover,mucoepidermoid carcinoma was the most frequent carcinoma in parotid gland,yet adnoid cystic carcinoma in submandibular gland and small salivary gland.Other pathologic types,such as salivary duct carcinoma,lymphoepithelial carcinoma,polymorphous low-grade adenocarcinoma,lymphoma,no-specific carcinoma were not rare,either.The overall 5- and 10- year survival rates of the 176 patients of parotid gland carcinoma was 83%and 67%.Univariate survival analysis showed that five factors were prognostic factors of parotid gland carcinoma,such as sex,lymph node metastasis,distant metastasis and pathology grade and pathology stage.Multivariate survival analysis revealed that lymph node metastasis(P<0.001),distant metastasis(P<0.001) and pathology grade(P=0.011) were independent prognostic factors.