A Comprehensive Analysis of Parotid and Salivary Gland Cancer: Worse Outcomes for Male Gender

• Published in: The Journal of surgical research 2011-11, Vol.171 (1), p.151-158
• Main Authors: Cheung, Michael C., M.D, Franzmann, Elizabeth, M.D, Sola, Juan E., M.D, Pincus, David J., M.D, Koniaris, Leonidas G., M.D
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Aged; Biological and medical sciences; Comorbidity; Female; gender disparities; General aspects; Humans; Male; Medical sciences; Middle Aged; Neoplasm Grading; Otorhinolaryngology. Stomatology; outcomes; parotid; Parotid Neoplasms - mortality; Parotid Neoplasms - pathology; Predictive Value of Tests; Prognosis; Risk Factors; salivary gland; Salivary Gland Neoplasms - mortality; Salivary Gland Neoplasms - pathology; Sex Distribution; Sublingual Gland Neoplasms - mortality; Sublingual Gland Neoplasms - pathology; Submandibular Gland Neoplasms - mortality; Submandibular Gland Neoplasms - pathology; Surgery; Survival Analysis; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2009.11.721

Background To determine the effects of patient demographics, socioeconomic status (SES) and clinical variables on outcomes for patients with salivary and parotid gland tumors. Methods Florida cancer registry and inpatient hospital data were queried for cancer of the salivary glands diagnosed between 1998 - 2002. Results A total of 1573 patients were identified. Women were diagnosed at a younger age (median age (years): women 60.8 versus men 64.3, P = 0.003). Men were more often diagnosed with high grade tumors (65.1% versus 41.9% for women, P < 0.001) and advanced disease stage (>stage III: 60.2 versus 49.4%, P < 0.001), but underwent surgical extirpation and received radiation at equal rates compared with women. Overall 5-year survival rates was superior in women (67.4% versus 55.6%, P = 0.001). By multivariate analysis, adjusted for patient comorbidities, age over 65 (HR 3.43 P = 0.008), advanced disease stage (HR 8.05 P < 0.001), and high tumor grade (HR 2.33, P < 0.001) were independent predictors of worse prognosis. Improved outcomes were observed for female gender (HR 0.68, P = 0.011). Tumors located in the parotid gland (HR 0.631 P = 0.003) and receiving both surgical extirpation and radiation were predictors of improved survival. Conclusion Salivary gland tumors carry a worse prognosis than tumors of the parotid. Male patients have worse outcomes.