Outcome of Surgery and Post-Operative Radiotherapy for Major Salivary Gland Carcinoma: Ten Year Experience from a Single Institute

Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns inpatients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT).Materials and
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 carcinomawho underwent at least two surgeries and received PORT in the immediate post-operative period of the lastperformed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meiermethod.
Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were locatedin the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirtynine 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-upwas 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurredwith a median time to recurrence of 16.9 months.
Conclusions: Surgery and PORT is an effective treatmentfor major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment withpostoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.