Abstract
Background
To report the outcomes and early to long term treatment complications among pediatric patients with major salivary gland malignancies treated at a single institution.
Materials and Method
This study was a retrospective case review set at a tertiary referral cancer center. Patients less than 19 years of age with a diagnosis of a major salivary gland malignancy were identified at the M. D. Anderson tumor database between 1953 and 2006.
Results
A total of 61 patients were identified, with equal gender distribution. The majority of tumors arose in the parotid gland (83%), and the most common pathology was mucoepidermoid carcinoma (46%). Lymphatic metastasis was identified in 37% of patients, nearly all with mucoepidermoid carcinoma. Although 65% of patients had prior treatment elsewhere, more than 75% of patients underwent surgical resection at our institution. External beam radiation was used in 45% of patients, with an average dose of 58.6 Gray. Average patient follow-up was 153 months. The overall survival rate was 93% at 5 years, and 26% developed a recurrence. A second primary was identified in 2 patients. Permanent facial paresis was noted in 7 patients (12%) and xerostomia in 1 patient (4%).
Conclusions
Survival of pediatric patients with major salivary gland carcinomas is favorable. Adverse outcomes were best predicted by tumor grade, margin status, and neural involvement. Radiation therapy is beneficial for locoregional control of disease, with acceptable long-term treatment sequelae, and without a significant risk for develo** second primary tumors. Survivorship issues need to be addressed in this patient population into adulthood.
Similar content being viewed by others
References
Hicks J, Flaitz C. Mucoepidermoid carcinoma of salivary glands in children and adolescents: assessment of proliferation markers. Oral Oncol. 2000;36:454–60.
Luna MA, Batsakis JG, el-Naggar AK. Salivary gland tumors in children. Ann Otol Rhinol Laryngol. 1991;100:869–71.
Shikhani AH, Johns ME. Tumors of the major salivary glands in children. Head Neck Surg. 1988;10:257–63.
Lack EE, Upton MP. Histopathologic review of salivary gland tumors in childhood. Arch Otolaryngol Head Neck Surg. 1988;114:898–906.
Guzzo M, Ferrari A, Marcon I, Collini P, Gandola L, Pizzi N, et al. Salivary gland neoplasms in children: the experience of the Istituto Nazionale Tumori of Milan. Pediatr Blood Cancer. 2006;47:806–10.
Conley J, Tinsley PP, Jr. Treatment and prognosis of mucoepidermoid carcinoma in the pediatric age group. Arch Otolaryngol. 1985;111:322–4.
Chong GC, Beahrs OH, Chen ML, Hayles AB. Management of parotid gland tumors in infants and children. Mayo Clin Proc. 1975;50:279–83.
Callender DL, Frankenthaler RA, Luna MA, Lee SS, Goepfert H. Salivary gland neoplasms in children. Arch Otolaryngol Head Neck Surg. 1992;118:472–6.
Bhattacharyya N, Fried MP. Determinants of survival in parotid gland carcinoma: a population-based study. Am J Otolaryngol. 2005;26:39–44.
Baker SR, Malone B. Salivary gland malignancies in children. Cancer. 1985;55:1730–6.
Ribeiro KdCB, Kowalski LP, Saba LMB, Camargo Bd. Epithelial salivary glands neoplasms in children and adolescents: a forty-four-year experience. Med Pediatr Oncol. 2002;39:594–600.
Hematology/Oncology AAOPSo. Long-term follow-up care for pediatric cancer survivors. Pediatrics. 2009;123:906–15.
Landier W, Bhatia S. Cancer survivorship: a pediatric perspective. Oncologist. 2008;13:1181–92.
Trobs RB, Mader E, Friedrich T, Bennek J. Oral tumors and tumor-like lesions in infants and children. Pediatr Surg Int. 2003;19:639–45.
Nasman M, Bjork O, Soderhall S, Ringden O, Dahllof G. Disturbances in the oral cavity in pediatric long-term survivors after different forms of antineoplastic therapy. Pediatr Dent. 1994;16:217–23.
Gevorgyan A, La Scala GC, Neligan PC, Pang CY, Forrest CR. Radiation-induced craniofacial bone growth disturbances. J Craniofac Surg. 2007;18:1001–7.
Hua C, Bass JK, Khan R, Kun LE, Merchant TE. Hearing loss after radiotherapy for pediatric brain tumors: effect of cochlear dose. Int J Radiat Oncol Biol Phys. 2008;72:892–9.
Schmiegelow M, Lassen S, Weber L, Poulsen HS, Hertz H, Muller J. Dosimetry and growth hormone deficiency following cranial irradiation of childhood brain tumors. Med Pediatr Oncol. 1999;33:564–71.
Merchant TE, Hua CH, Shukla H, Ying X, Nill S, Oelfke U. Proton versus photon radiotherapy for common pediatric brain tumors: comparison of models of dose characteristics and their relationship to cognitive function. Pediatr Blood Cancer. 2008;51:110–7.
Takeda A, Shigematsu N, Suzuki S, Fujii M, Kawata T, Kawaguchi O, et al. Late retinal complications of radiation therapy for nasal and paranasal malignancies: relationship between irradiated-dose area and severity. Int J Radiat Oncol Biol Phys. 1999;44:599–605.
National Cancer Policy Board (U.S.), Weiner SL, Simone JV. Childhood cancer survivorship: improving care and quality of life. Washington, D.C.: National Academies Press; 2003.
Shapiro NL, Bhattacharyya N. Clinical characteristics and survival for major salivary gland malignancies in children. Otolaryngol Head Neck Surg. 2006;134:631–4.
Acknowledgments
The authors gratefully acknowledge Dr. N. Kannan for technical assistance with this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kupferman, M.E., de la Garza, G.O., Santillan, A.A. et al. Outcomes of Pediatric Patients with Malignancies of the Major Salivary Glands. Ann Surg Oncol 17, 3301–3307 (2010). https://doi.org/10.1245/s10434-010-1165-2
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-010-1165-2