2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

TABLE OF CONTENTS Selected Recent Materials - Reproduced in this Study Guide

February 2019 SECTION 7 NEOPLASTIC AND INFLAMMATORY DISEASES OF THE HEAD AND NECK

ADDITIONAL REFERENCE MATERIAL…………………………………………. i - iii

I. Salivary A. Extent of surgery/non-parotid tumors

Aro K, Ho AS, Luu M, et al. Development of a novel salivary gland cancer lymph node staging system. Cancer . 2018; 124(15):3171-3180. EBM level 2+..............................................................................1-10

Summary : This article presents a retrospective observational study from the National Cancer Data Base of 4520 patients treated for salivary gland cancer with surgery and neck dissection with or without adjuvant radiation therapy. The study period was from 2004 to 2013. Univariate and multivariate analysis of multiple factors suggested that the absolute number of positive lymph nodes had a significant stepwise impact on patient outcomes and was more accurate in predicting prognosis than the AJCC 8th edition for lymph node metastasis. The number of lymph nodes involved exerted a greater influence on outcome than did extranodal extension and contralateral metastasis. Baddour HM Jr, Fedewa SA, Chen AY. Five- and 10-year cause-specific survival rates in carcinoma of the minor salivary gland. JAMA Otolaryngol Head Neck Surg . 2016; 142(1):67-73. EBM level 2+.................................................................................................................................................11-17 Summary : This is a retrospective, population-based study using the SEER database identifying 5334 patients with minor salivary gland cancers. Negative prognostic factors identified on multivariate analysis were primary site in the larynx or nasal cavity/sinuses and patient age > 75 years. Surgical intervention is demonstrated to have a positive prognostic influence on survival at 5 and 10 years. No association of survival with race, gender, or socioeconomic status was identified. By far, this is the largest study on minor salivary gland cancer in publication. Weaknesses include lack of tumor grade information and surgical intervention details. Lee RJ, Tan AP, Tong EL, et al. Epidemiology, prognostic factors, and treatment of malignant submandibular gland tumors: a population-based cohort analysis. JAMA Otolaryngol Head Neck Surg . 2015; 141(10):905-912. EBM level 2+...............................................................................................18-25 Summary : This is a retrospective, population-based, SEER-identified study of 2626 patients with primary malignancy of the submandibular salivary gland. Multivariate analysis revealed histology, stage at presentation, patient age, gender, tumor grade, and surgical resection to be predictive of overall and disease-specific survival. The study presents the largest data set on salivary tumors in publication.