Salivary Gland Cancer
Determining Your Prognosis
Your prognosis is a prediction of the outcome of your disease. Will you survive? Will the cancer come back? These are the big questions on most people’s minds after receiving a diagnosis of oral cancer. In general, doctors know there are several characteristics of the tumor that can tell you something about your chances of being cured.
The following aspects of the cancer may affect your prognosis.
| Stage | This is the most important factor that affects your chances of being cured. |
| Site | Major salivary gland cancers have a better prognosis than minor salivary gland cancers, though this may be because minor salivary gland cancers are at a greater stage when they are discovered and because it can be harder to completely remove them. |
| Type and Grade | How aggressive a tumor is, is actually based on the type and grade of tumor (as in the chart about low-risk and high-risk types of tumors above). |
| Spread to Lymph Nodes | This goes along with stage, but even without other factors, if there is evidence of growth to lymph nodes in the neck, there is a lower chance of cure. |
| The Tumor Margins | Some would argue that the ability to completely remove the tumor is the single most important factor that will indicate whether you will be cured. |
| Spread into Local Structures | Spread into large nerves, skin and bone has been shown to indicate a worse prognosis.14Wierzbicka M, Kopeć T, Szyfter W, Kereiakes T, Bem G. The presence of facial nerve weakness on diagnosis of a parotid gland malignant process. European Archives of Oto-Rhino-Laryngology 2012:1-6. |
It is very difficult to discuss prognosis without understanding all the details of your cancer, and this is a conversation you’re better off having in person with your doctor. To give you a percentage chance of cure is really difficult because cancer research looks at all sorts of different types of cancers and may include patients from long ago.
In general, for patients with cancer of the salivary glands, studies of large national databases have shown the following:29Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck in Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.
| Estimated Disease-Specific Survival at Five Years | Estimated Disease-Specific Survival at 10 Years | |
| Salivary Gland Cancer | Salivary Gland Cancer | |
| Stage I | 96% | 92% |
| Stage II | 77% | 67% |
| Stage III | 73% | 58% |
| Stage IV | 37% | 28% |
These databases have analyzed prognosis based on the grade of the cancer and have shown the following:29Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck in Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.
| Estimated Disease-Specific Survival at Five Years | Estimated Disease-Specific Survival at 10 Years | |
| Salivary Gland Cancer | Salivary Gland Cancer | |
| Grade I | 70% | 57% |
| Grade II | 60% | 47% |
| Stage III-IV | 39% | 29% |
Finally, these studies also looked at survival based on the type of salivary gland cancer:29Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck in Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.
| Estimated Disease-Specific Survival at Five Years | Estimated Disease-Specific Survival at 10 Years | |
| Salivary Gland Cancer | Salivary Gland Cancer | |
| Squamous Cell Carcinoma | 46% | 37% |
| Adenocarcinoma | 60% | 49% |
| Adenoid Cystic Carcinoma | 84% | 71% |
| Mucoepidermoid Carcinoma, Poorly Differentiated | 90% | 85% |
| Acinic Cell Carcinoma | 96% | 94% |
| Mucoepidermoid Carcinoma (Other) | 96% | 94% |
| Carcinoma in Pleomorphic Adenoma (Malignant Mixed Tumor) | 82% | 71% |
| Mucoepidermoid Carcinoma, Well Differentiated | 99% | 99% |
Just to be complete, a few other major studies have looked at survival as well, and they found the following results:
| Estimated Disease-Specific Survival at Five Years | Estimated Disease-Specific Survival at 10 Years (minor salivary gland cancer)16Schmidt RL, Hall BJ, Layfield LJ. A systematic review and meta-analysis of the diagnostic accuracy of ultrasound-guided core needle biopsy for salivary gland lesions. Am J Clin Pathol 2011;136:516-26. |
Estimated Disease-Specific Survival at 10 Years (adenoid cystic carcinoma)17Agulnik M, McGann CF, Mittal BB, Gordon SC, Epstein JB. Management of salivary gland malignancies: current and developing therapies. Oncol Rev (2008) 2:86–94. |
|
| Salivary Gland Cancer (all sites)* |
Minor Salivary Gland Cancers | Adenoid Cystic Carcinoma |
|
| 1966-1991 | 1966-1991 | ||
| Stage I | 77% | 83% | 75% |
| Stage II | 58% | 53% | 43% |
| Stage III | 51% | 35% | 15% |
| Stage IV | 30% | 24% | 15% |
*This Dutch study analyzed over 550 patients with salivary gland cancers of all sites including parotid gland (332 patients), submaxillary gland (76 patients), oral cavity minor salivary glands (129 patients) and laryngopharyngeal minor salivary glands (28 patients).
Estimated Disease-Specific Survival is the percentage of people with a specific cancer who are alive at a given time point, such as five years after diagnosis. It excludes people who may have died from a disease other than their cancer. It is probably the best estimate we have in these large national databases as to the prognosis of a particular type of cancer at each stage.
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