Definitive Local Therapy in cM1 Major Salivary Gland Cancer

Authors

Matthew Shneyderman, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Aman M. Patel, Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Devanshi Patel, Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Paul T. Cowan, Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Andrey Filimonov, Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Ghayoour S. Mir, Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Document Type

Journal Article

Publication Date

9-12-2025

Journal

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

DOI

10.1002/ohn.70015

Keywords

National Cancer Database; metastasis; salivary gland carcinoma; surgical resection; survival

Abstract

OBJECTIVE: To investigate the impact of surgical resection and radiotherapy on overall survival (OS) in clinically distantly metastatic (cM1) major salivary gland cancer (MSGC). STUDY DESIGN: Retrospective cohort study. SETTING: The 2006 to 2020 hospital-based National Cancer Database. METHODS: The 2006 to 2020 National Cancer Database was queried for patients with cM1 MSGC undergoing chemotherapy. Kaplan-Meier and Cox proportional hazards regression models were implemented. RESULTS: Of 700 patients satisfying inclusion criteria, 219 (37.8%) underwent chemotherapy alone (ie, no local therapy), 159 (27.4%) underwent low-dose chemoradiotherapy (CRT), 56 (9.7%) underwent high-dose CRT, 47 (8.1%) underwent surgical resection + chemotherapy, 47 (8.1%) underwent surgical resection + low-dose CRT, and 52 (9.0%) underwent surgical resection + high-dose CRT; 5-year OS was 10%, 12%, 34%, 25%, 23%, and 28%, respectively (P < .001). Patients undergoing surgical resection underwent high-dose radiotherapy more frequently (N = 53, 36.1% vs N = 56, 12.9%) but multiple-agent chemotherapy less frequently (N = 105, 62.5% vs N = 363, 75.3%) than those not undergoing surgical resection (P < .005). Compared with chemotherapy alone, surgical resection + chemotherapy (aHR 0.67, 95% confidence interval [CI] 0.53-0.86), high-dose CRT (aHR 0.55, 95% CI 0.41-0.73), and immunotherapy (aHR 0.49, 95% CI 0.35-0.69) were associated with higher OS on multivariable Cox regression (P < .01). CONCLUSIONS: A minority of patients with cM1 MSGC underwent surgical resection or high-dose CRT. Despite the high rate of PSM, surgical resection was associated with higher OS than chemotherapy alone. High-dose CRT was associated with the highest OS. Definitive local therapy may benefit select patients with cM1 MSGC. LEVEL OF EVIDENCE: IV.

APA Citation

Shneyderman, Matthew; Patel, Aman M.; Patel, Devanshi; Cowan, Paul T.; Filimonov, Andrey; and Mir, Ghayoour S., "Definitive Local Therapy in cM1 Major Salivary Gland Cancer" (2025). GW Authored Works. Paper 7959.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7959

Department

School of Medicine and Health Sciences Student Works