RESUMO
Sialoblastoma is a rare malignant salivary gland tumor. The aim of this study was to review the available published data on sialoblastoma in a comprehensive analysis of its clinicopathologic characteristics, treatment, and outcomes. An unrestricted electronic search was performed in the following databases: MEDLINE/PubMed, EMBASE, Scopus, Web of science, and gray literature databases. Eligibility criteria included publications with sufficient clinical, imaging, and histopathological information to confirm the diagnosis of sialoblastoma. Data were evaluated descriptively and analytically. A total of 52 studies met the eligibility criteria. In total, 62 patients were evaluated. There was no gender predilection, with the parotid being the most affected primary site (n = 28; 45.2%). In the log-rank test, there was a significant increase in disease-associated survival in patients younger than 1 year of age (82.8% vs. 44.4%; p = 0.003), individuals with lesions in major salivary glands (79.4% vs. 38.5%; p = 0.005), patients without metastases (77.8% vs. 14.3%; p = 0.011), encapsulated lesions (85.7% vs. 0%; p < 0.0001), congenital lesions (83.3% vs. 25.0%; p < 0.0001), and lesions that do not show perineural invasion (89.5% vs. 40%; p = 0.035). Kaplan-Meier curves estimated overall survival and disease-free survival at 5 years of 95.5% and 68.1%, respectively. In the multivariate Cox regression model, only the presence of metastasis was identified as an independent prognostic factor (hazard ratio [HR] = 9.81; p = 0.010). Although sialoblastoma presents good prognosis, the tumor has a high recurrence rate.
Assuntos
Neoplasias das Glândulas Salivares , Humanos , Neoplasias das Glândulas Salivares/terapia , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Glândula Parótida/patologia , Intervalo Livre de Doença , Intervalo Livre de Progressão , PrognósticoRESUMO
PURPOSE OF REVIEW: Minor salivary gland carcinomas (MiSGC) of the head and neck are a group of rare cancers with significant heterogeneity in histological types and with variable clinical behavior. This study aims to clarify the incidence, epidemiology, predictive factors, and outcome-based survival in a large cohort of patients treated at the Brazilian National Cancer Institute (BNCI) over a 20-year period by comparing and associating the results of current articles on the world stage. RECENT FINDINGS: The difficulty in developing an algorithm of treatment is due to the low number of cases when evaluated in a single institution and the variety of histological subtypes that have different behaviors and different treatments according to each anatomical location. We reviewed the experience of tertiary centers for the treatment of head and neck cancer and epidemiological studies from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute of the USA. The lack of consensus on the management of MiSGC requires further knowledge about the biological behaviors of these tumors, as the identification of predictive factor of failure and survival to adequate treatment intensity. The growing collaboration of different centers publishing their experience allows us to unify these samples to reach concrete conclusions about these tumors.
Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias das Glândulas Salivares , Humanos , Prognóstico , Glândulas Salivares Menores/patologia , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/terapia , Incidência , Estudos RetrospectivosRESUMO
Salivary gland carcinomas (SGC) are aggressive cancers that arise in minor and major salivary glands. Given the complexity and the multiple subtypes of this class of tumors, diagnosis and, treatment may be challenging for clinicians. Recently the tumor microenvironment, composed mainly of immune and stromal cells are been a target for treatment. Accumulating evidence indicates that cancer immunotherapies have made a significant impact on oncologic patients, however immunotherapeutic attempts in SGC have been shown limited improvement. Advances in the models that best translate aggressive SGC are needed for the development of clinical protocols grouping immunotherapies and other classes of drugs that will promote better responses in patients with advanced SGC stages. In this review, we introduced different experimental models for SGC with a focus on tumor microenvironment highlighting potential therapy applications for each model.
Assuntos
Carcinoma , Neoplasias das Glândulas Salivares , Humanos , Imunoterapia , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/terapia , Glândulas Salivares/patologia , Microambiente TumoralRESUMO
INTRODUCTION: Malignant tumors of the salivary glands are uncommon pathological entities, representing less than 5% of head and neck neoplasms. The prognosis of patients with malignant tumors of the salivary glands is highly variable and certain clinical factors can significantly influence overall survival. OBJECTIVE: To analyze the clinicopathologic and sociodemographic characteristics that influence survival in patients with malignant tumors of the salivary glands METHODS: This retrospective study analyzed sex, age, race, education level, tumor location, tumor size, lymph node involvement, distant metastasis, margin status, treatment type, marital status, method of health care access and 15-year overall survival in 193 patients with malignant tumors of the salivary glands. The X², log-rank Mantel-Cox, multinomial regression and Cox logistic regression tests were used (SPSS 20.0,p < 0.05). RESULTS: The most common histological types were adenocarcinoma (32.1%), adenoid cystic carcinoma (31.1%) and mucoepidermoid carcinoma (18.7%). The 15-year overall survival rate was 67.4%, with a mean of 116±6 months. The univariate analysis revealed that male sex (p = 0.026), age > 50 years (p=0.001), referral origin from the public health system (p=0.011), T stage (p= 0.007), M stage (p< 0.001), clinical stage (p< 0.001), compromised surgical margins (p= 0.013), and chemotherapy (p< 0.001) were associated with a poor prognosis. Multivariate analyses also showed that age > 50 years was independently associated with a poor prognosis (p= 0.016). The level of education was the only factor more prevalent in older patients (p= 0.011). CONCLUSION: Patients with malignant tumors of the salivary glands older than 50 years have a worse prognosis and an independent association with a low education level.
Assuntos
Adenocarcinoma , Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Neoplasias das Glândulas Salivares , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Fatores Etários , Idoso , Carcinoma Adenoide Cístico/mortalidade , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/terapia , Carcinoma Mucoepidermoide/mortalidade , Carcinoma Mucoepidermoide/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/mortalidade , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/terapia , Fatores Sexuais , Fatores Sociodemográficos , Taxa de SobrevidaRESUMO
In numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a meta-analysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrence-free survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
Assuntos
Neoplasias das Glândulas Salivares , Humanos , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias das Glândulas Salivares/terapia , Análise de SobrevidaRESUMO
El carcinoma del conducto salival es un tumor epitelial maligno agresivo, que involucra principalmente a la glándula parótida, con características histológicas semejantes al carcinoma ductal de glándula mamaria. El propósito de este trabajo fue presentar los resultados clínico-patológicos de cinco casos de carcinoma del conducto salival primario de glándula parótida y evaluar la expresión de Ki67. Histológicamente, el carcinoma del conducto salival presentó nidos epiteliales con patrones papilar, sólido y cribiforme, comedonecrosis tanto en la lesión primaria como en los nodos linfoides metastásicos y, además, invasión perineural. Se demostró con Ki 67 una alta proliferación celular en cuatro (80 %) de los cinco casos estudiados. Se concluyó que: el carcinoma del conducto salival es una lesión maligna de mal pronóstico, raramente informado en la literatura odontológica, con características histológicas semejantes a las del carcinoma ductal de alto grado de la mama; la comedonecrosis es un signo específico de esta enfermedad; puede desarrollarse "de novo" o en un adenoma pleomórfico preexistente; su diagnóstico diferencial histopatológico es fundamental para planificar su tratamiento y determinar su pronóstico, a pesar de su tratamiento quirúrgico y radioterapia postoperatoria es un tumor agresivo con alta proliferación celular, infiltración perineural, recurrencias y metástasis.
Salivary duct carcinoma is an aggressive malignant epithelial tumor, primarily involving the parotid gland, with histologic features similar to ductal carcinoma of the breast. The purpose of this work was to report the clinicopathological results of five cases of primary salivary duct carcinoma of the parotid gland and evaluate the expression of Ki67. Histologically, salivary duct carcinoma presented epithelial nests with papillary, solid, and cribriform patterns, with comedonecrosis in both the primary lesion and the metastatic limph nodes, and perineural invasion. A high cell proliferation was demonstrated with Ki67 in four (80 %) of the five cases studied. We concluded that: salivary duct carcinoma is a malignant lesion with a poor prognosis, rarely reported in the dental literature, with histological characteristics similar to those of high-grade ductal carcinoma of the breast; comedonecrosis is a specific sign of this disease; may develop "de novo" or in a pre-existing pleomorphic adenoma; its differential histopathological diagnosis is essential to plan its treatment and determine its prognosis; despite its surgical treatment and postoperative radiotherapy, it is an aggressive tumor with high cell proliferation, perineural infiltration, recurrences and metastasis.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias das Glândulas Salivares/patologia , Biomarcadores Tumorais/genética , Carcinoma Ductal/patologia , Neoplasias das Glândulas Salivares/genética , Neoplasias das Glândulas Salivares/terapia , Imuno-Histoquímica/métodos , Antígeno Ki-67 , Carcinoma Ductal/genética , Carcinoma Ductal/terapiaRESUMO
BACKGROUND: Salivary gland cancers (SGC) represent an uncommon group of heterogeneous tumors. We performed a retrospective survey of SGC diagnosed in a reference center for treatment of malignant tumors from the south of Brazil aiming to determine the prognostic value of demographic, clinic and pathologic features. MATERIAL AND METHODS: Cases diagnosed as SGC between 2006 and 2016 were retrospectively collected. Medical records were examined to extract demographic, clinic, pathologic and follow-up information. RESULTS: One-hundred and seven cases of SGC were identified. The most common SGC were mucoepidermoid carcinoma (MEC) (n = 39) followed by adenoid cystic carcinoma (AdCC) (n = 29). Among AdCCs, 55.2% of cases were classified as cribriform, 27.6% as tubular and 17.2% as solid. The tubular subtype had the highest percentage of cases with perineural invasion (p=0.01). Among MEC, 61.5% of cases were classified as low grade, 15.4% as intermediate grade and 19.9% as high grade. Low grade MEC had the lowest percentage of cases with perineural invasion (p=0.04). The 5-year survival for loco-regional control, disease-free survival (DFS) and disease-specific survival were 75%, 70% and 84%, respectively. The following features were associated with poor DFS: advanced age (p=0.03), rural residency (p=0.01), being a smoker or former smoker (p=0.01), pain (p=0.03), nodal metastasis (p<0.001), need for chemotherapy (p=0.02), neck dissection (p=0.04), perineural invasion (p=0.01), and being diagnosed with AdCC compared to MEC (p=0.02). CONCLUSIONS: The clinco-demographic and pathologic features identified as prognostic factors reveal the profile of patients at increased risk of recurrence and who would benefit from closer follow-up.
Assuntos
Recidiva Local de Neoplasia , Neoplasias das Glândulas Salivares , Brasil/epidemiologia , Humanos , Prognóstico , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias das Glândulas Salivares/terapiaRESUMO
BACKGROUND: Salivary gland tumors are a diverse group of uncommon neoplasms that are rare in pediatric patients. The aim of this study was to evaluate the clinicopathological profile and survival outcomes of pediatric patients affected by salivary gland tumors. MATERIALS AND METHODS: An extensive search was carried out using the MEDLINE/PubMed, EMBASE, Scopus databases, and grey literature. The risk of bias was available in all papers included. RESULTS: A total of 2,830 articles were initially retrieved with 54 remaining for data extraction, resulting in 2,937 cases. This comprised forty-five case series' and nine cohort studies. These tumors were slightly more prevalent in females (57.4%). The patients' age ranged from 0.3 to 19 years old, with a mean age of 13.3 years. Parotid was the most affected site (81.9%), and 99.2% of cases clinically exhibited a swelling. Presence of pain/tenderness was reported in 13.5% of the cases, with an average duration of 12.6 months for the appearance of symptoms. Most of the reported cases were malignant tumors (75.4%), with mucoepidermoid carcinoma the most common tumor of all tumors (44.8%), followed by pleomorphic adenoma (24.1%). Surgery alone was the leading treatment choice in 74.9% cases, and the 5-year overall survival rate of patients was 93.1%. Patients with symptoms (P = .001), local recurrence (P < .001), metastasis (P < .001), and those not undergoing surgery or surgery combined with radiotherapy (P < .001) showed lower survival rates. CONCLUSION: The pediatric patients present a high frequency of malignant salivary neoplasms and a high overall survival rate.
Assuntos
Adenoma Pleomorfo , Carcinoma Mucoepidermoide , Neoplasias das Glândulas Salivares , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recidiva Local de Neoplasia , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias das Glândulas Salivares/terapia , Taxa de Sobrevida , Adulto JovemRESUMO
OBJECTIVE: Mucoepidermoid Carcinoma (MEC) is the most common malignant salivary gland neoplasm, representing 10 to 15% of all salivary neoplasms. A review of the literature was conducted in order to determine trends in presentation, diagnostic features, treatment, and outcomes. METHODS: A PubMed, Embase, and Scopus search was carried out. The search process was performed by 2 independent reviewing authors and inclusion criteria included systematic reviews, meta-analyses, case-controls studies, cohort studies, comparative studies, clinical trials, cross-sectional studies, descriptive studies, experimental studies, case reports, case series studies, and human studies evaluating MEC. RESULTS: Females were more affected (54.5%) and the average age was 48.8 years. The most common location of MEC was the parotid glands (56.8%) followed by hard palate (18%). The most frequent clinical presentation was mass (65.2%) followed by ulcer (29.4%) with pressure as their main symptom (64.4%). The most frequent histologic presentation was Low grade (46.7%) followed by Intermediate grade (27.3%) and the most used treatment was surgery (76.2%). The average follow up was 138.5months, and recurrence was reported at 8.5%. CONCLUSION: MEC showed a strong predilection for the parotid glands is frequently painful, most frequently presents as a mass and most commonly has a low-grade histologic presentation.
Assuntos
Carcinoma Mucoepidermoide , Neoplasias das Glândulas Salivares , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/epidemiologia , Carcinoma Mucoepidermoide/cirurgia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Glândula Parótida , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias das Glândulas Salivares/terapiaRESUMO
Salivary gland cancers represent a rare group of tumors composed by over 20 histological subtypes. Initially treated as one single disease, its diagnosis, prognosis, and treatment are currently being stratified based on morphology. More recently, insight has been provided on the molecular characterization of each subtype, further improving diagnostic accuracy and paving the way for personalized therapy. In this article, we provide a comprehensive review of recent breakthroughs, preliminary results of novel therapy, and future directions on the treatment of these complex malignancies.