Salivary duct carcinoma: Treatment, outcomes, and patterns of failure.
Salivary duct carcinoma is rare, with distinct morphology and behavior. We reviewed our institutional experience with salivary duct carcinoma, aiming to characterize clinical behavior and treatment outcomes.



All salivary duct carcinomas treated curatively between 1999 and 2010 were reviewed. Overall survival (OS), locoregional control, distant control, and patterns of failure were analyzed. Multivariate analysis identified predictors of OS.



Fifty-four patients with salivary duct carcinoma (parotid gland = 49; submandibular gland = 5) were included in the analysis. Fifty-three patients underwent primary surgery, and 48 (89%) received postoperative radiotherapy (RT; median dose = 60 Gy). Median follow-up was 5.7 years. The 5-year OS, locoregional control, and distant control were 43%, 70%, and 48%, respectively. Nine local (6 involving facial nerve), 10 regional, and 28 distant failures were identified. Multiple pathologic involved lymph nodes (pN2b/N2c) predicted reduced OS (hazard ratio [HR] = 3.6; p = .02).



Distant recurrence is common. Presence of pN2b/N2c disease is associated with reduced OS. Local recurrence frequently involves the facial nerves. © 2015 Wiley Periodicals, Inc. Head Neck 38: E820-E826, 2016.
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Meredith L
ML
Johnston
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Shao Hui
SH
Huang
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
John N
JN
Waldron
Department of Biostatistics, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Eshetu G
EG
Atenafu
Department of Medical Oncology Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Kelvin
K
Chan
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Bernard J
BJ
Cummings
Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Ralph W
RW
Gilbert
Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
David
D
Goldstein
Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Patrick J
PJ
Gullane
Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Jonathan C
JC
Irish
Department of Pathology, University Health Network, Toronto, Ontario, Canada.
Bayardo
B
Perez-Ordonez
Department of Pathology, University Health Network, Toronto, Ontario, Canada.
Ilan
I
Weinreb
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Andrew
A
Bayley
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
John
J
Cho
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Laura A
LA
Dawson
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Andrew
A
Hope
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Jolie
J
Ringash
Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Ian J
IJ
Witterick
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Brian
B
O'Sullivan
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
John
J
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010306:Parotid Gland / Q000473:pathology; D012189:Retrospective Studies; D018987:Salivary Ducts / Q000473:pathology; D012468:Salivary Gland Neoplasms / Q000473:pathology* / Q000628:therapy*; D013363:Submandibular Gland / Q000473:pathology; D017211:Treatment Failure; D016896:Treatment Outcome
head and neck; pattern of failure; radiotherapy; salivary duct carcinoma; surgery