title: Outcome of surgery and post-operative radiotherapy for major salivary gland carcinoma: ten year experience from a single institute.
abstract: OBJECTIVE
  To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT).
  
  
  METHODS
  We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method.
  
  
  RESULTS
  Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months.
  
  
  CONCLUSIONS
  Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.
authors.affiliation: All India Institute of Medical Sciences, New Delhi, India E-mail : drjaspreet.ro@gmail.com.
authors.forename: Jaspreet
authors.initials: J
authors.lastname: Kaur
authors.forename: Shikha
authors.initials: S
authors.lastname: Goyal
authors.forename: Sandeep
authors.initials: S
authors.lastname: Muzumder
authors.forename: Suman
authors.initials: S
authors.lastname: Bhasker
authors.forename: Bidhu Kalyan
authors.initials: BK
authors.lastname: Mohanti
authors.forename: Goura Kishore
authors.initials: GK
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018277:Carcinoma, Mucoepidermoid / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult