title: Clinical outcome of patients with carcinoma ex pleomorphic adenoma of the parotid gland: a comparative study from a single tertiary center.
abstract: BACKGROUND
  Carcinoma ex pleomorphic adenoma (CXPA) of the parotid gland is a high-grade cancer and the prognosis of this cancer has not been compared with non-CXPA high-grade primary parotid cancer.
  
  
  METHODS
  Retrospective medical chart review of patients with surgically treated high-grade primary parotid cancer (21 CXPA and 52 non-CXPA) was performed with correlation with disease-specific survival, locoregional recurrence, and distant recurrence.
  
  
  RESULTS
  Despite having similar stage of cancer and extent of surgical resection, patients with CXPA had a lower disease-specific survival compared to non-CXPA high-grade primary parotid cancer (p = .02). Salivary duct cancer (SDC) was the commonest histologic variant in both cohorts and around 40% of patients with SDC died of distant recurrence that occurred within 3 years from diagnosis.
  
  
  CONCLUSIONS
  CXPA of the parotid gland is a more aggressive cancer compared to non-CXPA high-grade primary parotid cancer. SDC was associated with a high chance of delayed distant recurrence, which contributed directly to the mortality of this cancer.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania; Department of Otolaryngology Head and Neck Surgery, National University Health System, Singapore.
authors.forename: Chwee Ming
authors.initials: CM
authors.lastname: Lim
authors.forename: Candace
authors.initials: C
authors.lastname: Hobson
authors.forename: Seungwon
authors.initials: S
authors.lastname: Kim
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
mesh_terms: D008949:Adenoma, Pleomorphic / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016896:Treatment Outcome
keywords: carcinoma ex pleomorphic adenoma; clinical outcome; parotid cancer; salivary duct carcinoma