title: Predictors of survival in carcinoma ex pleomorphic adenoma.
abstract: BACKGROUND
  Carcinoma ex pleomorphic adenoma (Ca ex PA) is a high-grade carcinoma arising from benign pleomorphic adenoma. This is the first population-level analysis of prognosis and prognostic features of parotid Ca ex PA.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results (SEER) database (1988-2009) was used to identify 278 patients with parotid Ca ex PA.
  
  
  RESULTS
  Extraparenchymal extension of the primary tumor was associated with cervical metastasis (35.7% vs 2.9%; p < .001). Independent predictors of disease-specific survival (DSS) were race (hazard ratio [HR], 7.12; 95% confidence interval [CI], 2.56-19.82), distant metastases (HR, 18.99; 95% CI, 5.06-71.21), and multiple metastatic lymph nodes (HR, 9.48; 95% CI, 4.14-21.71). Patients with multiple cervical lymph node metastases had decreased 5-year DSS compared with patients with ≤1 positive lymph node (42.7% vs 85.9%; p < .001).
  
  
  CONCLUSIONS
  The presence of 2 or more cervical lymph node metastases identifies patients with Ca ex PA with a poor prognosis.
authors: Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors: Michelle M
authors: MM
authors: Chen
authors: Sanziana A
authors: SA
authors: Roman
authors: Julie A
authors: JA
authors: Sosa
authors: Benjamin L
authors: BL
authors: Judson
mesh_terms: D008949:Adenoma, Pleomorphic / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: carcinoma ex pleomorphic adenoma; metastases; parotid; salivary; survival