Impact of Local Radiation in the Management of Salivary Gland Carcinomas

Seventy patients with salivary gland carcinoma (63% major gland and 37% minor gland) are reviewed. Histologies included adenoid cystic (54%), mucoepidermoid (16%), and adenocarcinoma (14%). Patients were analyzed according to extent of surgery and whether or not adjuvant postoperative radiotherapy was given. There is no difference in survival in patients who had complete excision of gross tumor with or without adjuvant radiotherapy. Patients who did not undergo radiotherapy had a 62% actuarial risk of locoregional failure at 5 years, with a 20% risk in the adjuvantly irradiated group (P less than 0.001). A failure analysis demonstrates that among the 44% of patients with recurrence 71% (22/31) failed locoregionally and 69% (21/31) had distant metastases. Twenty-seven percent (19/70) died of disease, with 31% (6/19) dying of locoregional disease and 26% (5/19) of distant disease. Implications for management are discussed.