Salivary Duct Carcinoma: A Clinicopathologic Analysis and Treatment Outcome

Jeong, Han Sin; Lee, Hyun Seok; Lee, Hyeok Jun; Koh, Young Hyeh; Baek, Chung Hwan; Son, Young Ik

Abstract

BACKGROUND AND OBJECTIVES
Salivary duct carcinoma (SDC) is a rare but highly malignant tumor of the salivary glands. Authors aimed to assess the current treatment outcome and to estimate the prognostic factors in the patients with SDC. MATERIALS AND METHODS: We reviewed the medical records of 11 patients with SDC, who were treated between Jan. 1995 and Jun. 2002 at the Department of Otolaryngology, Samsung Medical Center. Follow-up duration ranged from 10 to 76 months with a mean of 29.6. RESULTS: The parotid glands were more frequently involved (9 patients) than the submandibular glands (2 patients). Most patients were diagnosed to have an advanced stage of the disease. Curative surgical resections and/or postoperative radiation were the mainstay of the treatment. The adjusted 3-year survival rate was 64.9% and the disease-free 3-year survival rate was 34.1%. Four patients died of the disease at a mean interval of 22 months after the initial diagnosis. Presentation with the facial nerve paralysis, positive surgical resection margins and pathological vascular invasion had a tendency to result in poor survivals. Treatment failures due to distant metastasis were common (54.5%). CONCLUSION: We reconfirmed the aggressive clinical natures of SDC: frequent distant metastasis and poor survival rates. These findings strongly suggest that additional treatment modalities such as an adjunctive systemic treatment need to be considered in the patients with SDC especially when they have high risk factors or an advanced disease, which need further investigation.