Prognostic factors in major salivary gland cancer

Objective. To identify features of major salivary gland cancers that are pr ognostic for disease-free survival. Study Design: A retrospective study of 78 patients with major salivary gland cancer (64 parotid and 14 submandibul ar gland) who underwent surgery for definitive treatment from 1976 to 1996. A select group of patients also received adjuvant radiation (56%) and/or c hemotherapy (13%). Method: Clinical and pathological risk factors were obta ined from patients' charts and pathology reports. Age, gender, tumor site, T-stage, facial paralysis, histologic neck involvement, perineural invasion , and cancer grade were analyzed with respect to disease-free survival. The role of adjuvant treatment in terms of clinical outcome was also investiga ted. Results: In our series, the 5-year disease-free survival was 65%. Exam ining clinical and histologic features one at a time, we found poorer progn osis was associated with submandibular tumors compared with parotid (P = .0 2), higher T-stage (P = .001), positive cervical nodes (P < .001), perineur al invasion (P = .002), and high-grade or adenoid cystic tumors (P = .002). A multivariable analysis indicated that positive lymph nodes (P = .07) and perineural invasion (P = .03) were important histologic predictors of shor ter disease-free survival. Receipt of both adjuvant radiation and cisplatin -based chemotherapy (P = .05) was an independent predictor of longer diseas e-free survival. Conclusion: Our study indicated that the presence of posit ive lymph nodes and perineural invasion is important independent predictors of disease-free survival. Our limited data also suggest that adjuvant chem otherapy and radiation therapy may improve disease-free survival.