title: Outcomes of pediatric patients with malignancies of the major salivary glands.
abstract: BACKGROUND
  To report the outcomes and early to long term treatment complications among pediatric patients with major salivary gland malignancies treated at a single institution.
  
  
  METHODS
  This study was a retrospective case review set at a tertiary referral cancer center. Patients less than 19 years of age with a diagnosis of a major salivary gland malignancy were identified at the M. D. Anderson tumor database between 1953 and 2006.
  
  
  RESULTS
  A total of 61 patients were identified, with equal gender distribution. The majority of tumors arose in the parotid gland (83%), and the most common pathology was mucoepidermoid carcinoma (46%). Lymphatic metastasis was identified in 37% of patients, nearly all with mucoepidermoid carcinoma. Although 65% of patients had prior treatment elsewhere, more than 75% of patients underwent surgical resection at our institution. External beam radiation was used in 45% of patients, with an average dose of 58.6 Gray. Average patient follow-up was 153 months. The overall survival rate was 93% at 5 years, and 26% developed a recurrence. A second primary was identified in 2 patients. Permanent facial paresis was noted in 7 patients (12%) and xerostomia in 1 patient (4%).
  
  
  CONCLUSIONS
  Survival of pediatric patients with major salivary gland carcinomas is favorable. Adverse outcomes were best predicted by tumor grade, margin status, and neural involvement. Radiation therapy is beneficial for locoregional control of disease, with acceptable long-term treatment sequelae, and without a significant risk for developing second primary tumors. Survivorship issues need to be addressed in this patient population into adulthood.
authors.affiliation: Department of Head & Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA. mekupfer@mdanderson.org
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kupferman
authors.forename: Gabriel O
authors.initials: GO
authors.lastname: de la Garza
authors.forename: Alfredo A
authors.initials: AA
authors.lastname: Santillan
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
authors.forename: Bipin T
authors.initials: BT
authors.lastname: Varghese
authors.forename: Winston
authors.initials: W
authors.lastname: Huh
authors.forename: Dianna
authors.initials: D
authors.lastname: Roberts
authors.forename: Randal S
authors.initials: RS
authors.lastname: Weber
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000628:therapy*; D018277:Carcinoma, Mucoepidermoid / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult