title: Prognostic factors in major salivary gland cancer.
abstract: OBJECTIVE
  To identify features of major salivary gland cancers that are prognostic for disease-free survival.
  
  
  METHODS
  A retrospective study of 78 patients with major salivary gland cancer (64 parotid and 14 submandibular gland) who underwent surgery for definitive treatment from 1976 to 1996. A select group of patients also received adjuvant radiation (56%) and/or chemotherapy (13%).
  
  
  METHODS
  Clinical and pathological risk factors were obtained from patients' charts and pathology reports. Age, gender, tumor site, T-stage, facial paralysis, histologic neck involvement, perineural invasion, and cancer grade were analyzed with respect to disease-free survival. The role of adjuvant treatment in terms of clinical outcome was also investigated.
  
  
  RESULTS
  In our series, the 5-year disease-free survival was 65%. Examining clinical and histologic features one at a time, we found poorer prognosis was associated with submandibular tumors compared with parotid (P =.02), higher T-stage (P =.001), positive cervical nodes (P <.001), perineural invasion (P =.002), and high-grade or adenoid cystic tumors (P =.002). A multivariable analysis indicated that positive lymph nodes (P =.07) and perineural invasion (P =.03) were important histologic predictors of shorter disease-free survival. Receipt of both adjuvant radiation and cisplatin-based chemotherapy (P =.05) was an independent predictor of longer disease-free survival.
  
  
  CONCLUSIONS
  Our study indicated that the presence of positive lymph nodes and perineural invasion is important independent predictors of disease-free survival. Our limited data also suggest that adjuvant chemotherapy and radiation therapy may improve disease-free survival.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University, 540 East Canfield Avenue, Detroit, MI 48201, U.S.A.
authors.forename: E
authors.initials: E
authors.lastname: Hocwald
authors.forename: H
authors.initials: H
authors.lastname: Korkmaz
authors.forename: G H
authors.initials: GH
authors.lastname: Yoo
authors.forename: V
authors.initials: V
authors.lastname: Adsay
authors.forename: T Y
authors.initials: TY
authors.lastname: Shibuya
authors.forename: J
authors.initials: J
authors.lastname: Abrams
authors.forename: J R
authors.initials: JR
authors.lastname: Jacobs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010307:Parotid Neoplasms / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013365:Submandibular Gland Neoplasms / Q000401:mortality* / Q000473:pathology