Clinical and Prognostic Factors of Submandibular Gland Malignancies: A SEER Analysis

Monday, September 30, 2024

4:06 PM – 4:12 PM EDT

Location: MBCC, 208

Disclosure(s):

Priya Arya, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mikalah E. Maury, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kimberly B. Roth, PhD, MHS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David Hernan D. Posas, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Relative to other salivary glands, the submandibular gland (SMG) has a higher rate of malignancy and its neoplasms are associated with poorer prognoses. Clinical and prognostic information relating to these tumors is limited; we aimed to elucidate these factors using an analysis of the Surveillance, Epidemiology, and End Results (SEER) database.

Methods: Data regarding primary SMG malignancy from 2000-2019 was extracted from the SEER database. Kaplan-Meier curves and log-rank tests assessed differences in survival by tumor grade and treatment. Multivariate Cox models estimated relative hazard of death. Stratified analyses were conducted by tumor stage and histology subtype.

Results: Data from 2,875 patients was extracted. Kaplan-Meier analyses showed survival differing significantly by tumor grade, histologic subtype, surgery, and chemotherapy (p < 0.0001), but not radiation. Most favorable survival outcomes were amongst mucoepidermoid and ductal/lobular neoplasms, and least were amongst squamous cell and epithelial neoplasms. Hazard of death was significantly increased with higher-grade tumors, particularly amongst Grade III (HR=3.98, p=0.005) and IV (HR=4.81, p=0.003). Those receiving surgery or radiation alone had significantly lower hazard of death (HR=0.11, p< 0.001 and HR=0.59, p=0.001) and those receiving only chemotherapy significantly higher (HR=1.73, p< 0.001). There were significant interactions between surgery and chemotherapy (HR=1.87, p< 0.001) and radiation and chemotherapy (HR=0.65, p=0.009), but surgery and radiation was non-significant. Surgery and radiation were both most protective among those with adenomas and adenocarcinomas (HR=0.14, p< 0.001 and HR=0.40, p=0.001, respectively), while chemotherapy had the highest hazard of death (HR=2.49, p< 0.001).

Conclusions: Multivariate analysis indicated hazard of death as lower with surgery and higher with chemotherapy, likely due to the latter patients being poor surgical candidates. Radiation therapy had a lesser impact on survival. Optimal treatment modalities for SMG malignancies are still being determined.

Presenting Author(s)

Priya Arya, BS

Medical Student
Mercer University School of Medicine
Smyrna, GA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Mikalah E. Maury, BS

Medical Student
Mercer University School of Medicine
Savannah, GA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Kimberly B. Roth, PhD, MHS

Assistant Professor
Mercer University School of Medicine
Savannah, GA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
David Hernan D. Posas, BS

David H. Posas
Mercer University School of Medicine
Savannah, GA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
RL

Robert Liebman, MD

Memorial Hospital University Medical Center, United States

Disclosure information not submitted.

Senior Author(s)

MO

Matthew Ochsner, MD

Memorial Hospital University Medical Center, United States

Disclosure information not submitted.