Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck
Objective Clear cell carcinoma (CCC) is a rare salivary gland malignancy, believed to be generally low grade. We investigated CCC epidemiology and clinical behavior, using the National Cancer Database (NCDB). Study Design Retrospective cohort study. Setting NCDB. Subjects and Methods All CCCs of the...
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| creator | Oliver, Jamie Wu, Peter Chang, Clifford Roden, Dylan Wang, Binhuan Liu, Cheng Hu, Kenneth Schreiber, David Givi, Babak |
| description | Objective
Clear cell carcinoma (CCC) is a rare salivary gland malignancy, believed to be generally low grade. We investigated CCC epidemiology and clinical behavior, using the National Cancer Database (NCDB).
Study Design
Retrospective cohort study.
Setting
NCDB.
Subjects and Methods
All CCCs of the salivary glands were selected between 2004 and 2015. Patient demographics, tumor characteristics, treatments, and survival were analyzed. Cox regression analyses were performed in treated patients.
Results
We identified 268 patients with CCC. Median age was 61 (21-90) years. Most were female (145, 54%). The most common site was oral cavity (119, 44%), followed by major salivary glands (68, 25%) and oropharynx (41, 15%). Most tumors were low grade (81, 68%) and stages I to II (117, 60.6%). Nodal (36, 17.5%) and distant metastases (6, 2.4%) were rare. Most were treated by surgery alone (134, 50.0%), followed by surgery and radiotherapy (69, 25.7%). Five-year overall survival (OS) was 77.6% (95% CI, 71.4%-84.2%). In univariate analysis, older age, major salivary gland and sinonasal site, stages III to IV, high grade, and positive margins were associated with worse OS. In multivariate analysis, only high tumor grade (hazard ratio [HR], 5.76; 95% CI, 1.39-23.85; P = .02), positive margins (HR, 4.01; 95% CI, 1.20-13.43; P = .02), and age ≥60 years (HR, 3.45; 95% CI, 1.39-8.55; P = .01) were significantly associated with OS.
Conclusion
We report the largest series of clear cell carcinomas of the head and neck. Outcomes are generally favorable following surgical-based treatments. In this series, pathologic tumor grade is associated with worse survival. Routine evaluation and reporting of tumor grade might better guide physicians in recommending appropriate treatments in this rare malignancy. |
| doi_str_mv | 10.1177/0194599819835779 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2190483984</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0194599819835779</sage_id><sourcerecordid>2190483984</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4527-6d99d4b548560802a0ee80e76b34be110d922fdc4250a6e85ac77fef2338a8e33</originalsourceid><addsrcrecordid>eNqFkL1PwzAUxC0EoqWwM6GMLAE7tmN7hIrSSlXLALPlOC-Qko9iJ0L970mawoCEmJ707nen0yF0SfANIULcYqIYV0oSJSkXQh2hMcFKhLEk4hiNezns9RE6836DMY5jIU7RiGLJBZPxGC2eTNOAq3xQZ8HUOAhMlQbrtrF1CftfAcYFUyiKXrZ5VZem_zdvEMzBpHt-Bfb9HJ1kpvBwcbgT9DJ7eJ7Ow-X6cTG9W4aW8airliqVsoQzyWMscWQwgMQg4oSyBAjBqYqiLLUs4tjEILmxQmSQRZRKI4HSCboecreu_mjBN7rMve36mQrq1uuIKMwkVZJ1KB5Q62rvHWR66_LSuJ0mWPcD6t8DdparQ3qblJD-GL4X6wA5AJ95Abt_A_V6vrqfkYgr0VnDwerNK-hN3bqqG-rvLl-RW4WJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2190483984</pqid></control><display><type>article</type><title>Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>Sage Journals Online</source><creator>Oliver, Jamie ; Wu, Peter ; Chang, Clifford ; Roden, Dylan ; Wang, Binhuan ; Liu, Cheng ; Hu, Kenneth ; Schreiber, David ; Givi, Babak</creator><creatorcontrib>Oliver, Jamie ; Wu, Peter ; Chang, Clifford ; Roden, Dylan ; Wang, Binhuan ; Liu, Cheng ; Hu, Kenneth ; Schreiber, David ; Givi, Babak</creatorcontrib><description>Objective
Clear cell carcinoma (CCC) is a rare salivary gland malignancy, believed to be generally low grade. We investigated CCC epidemiology and clinical behavior, using the National Cancer Database (NCDB).
Study Design
Retrospective cohort study.
Setting
NCDB.
Subjects and Methods
All CCCs of the salivary glands were selected between 2004 and 2015. Patient demographics, tumor characteristics, treatments, and survival were analyzed. Cox regression analyses were performed in treated patients.
Results
We identified 268 patients with CCC. Median age was 61 (21-90) years. Most were female (145, 54%). The most common site was oral cavity (119, 44%), followed by major salivary glands (68, 25%) and oropharynx (41, 15%). Most tumors were low grade (81, 68%) and stages I to II (117, 60.6%). Nodal (36, 17.5%) and distant metastases (6, 2.4%) were rare. Most were treated by surgery alone (134, 50.0%), followed by surgery and radiotherapy (69, 25.7%). Five-year overall survival (OS) was 77.6% (95% CI, 71.4%-84.2%). In univariate analysis, older age, major salivary gland and sinonasal site, stages III to IV, high grade, and positive margins were associated with worse OS. In multivariate analysis, only high tumor grade (hazard ratio [HR], 5.76; 95% CI, 1.39-23.85; P = .02), positive margins (HR, 4.01; 95% CI, 1.20-13.43; P = .02), and age ≥60 years (HR, 3.45; 95% CI, 1.39-8.55; P = .01) were significantly associated with OS.
Conclusion
We report the largest series of clear cell carcinomas of the head and neck. Outcomes are generally favorable following surgical-based treatments. In this series, pathologic tumor grade is associated with worse survival. Routine evaluation and reporting of tumor grade might better guide physicians in recommending appropriate treatments in this rare malignancy.</description><identifier>ISSN: 0194-5998</identifier><identifier>EISSN: 1097-6817</identifier><identifier>DOI: 10.1177/0194599819835779</identifier><identifier>PMID: 30857486</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma - mortality ; Carcinoma - pathology ; Carcinoma - therapy ; clear cell carcinoma ; Female ; head and neck cancer ; Humans ; hyalinizing clear cell carcinoma ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; New York City ; Retrospective Studies ; Risk Factors ; salivary gland cancer ; Salivary Gland Neoplasms - mortality ; Salivary Gland Neoplasms - pathology ; Salivary Gland Neoplasms - therapy ; Survival Analysis</subject><ispartof>Otolaryngology-head and neck surgery, 2019-07, Vol.161 (1), p.98-104</ispartof><rights>American Academy of Otolaryngology–Head and Neck Surgery Foundation 2019</rights><rights>2019 American Association of Otolaryngology‐Head and Neck Surgery Foundation (AAO‐HNSF)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4527-6d99d4b548560802a0ee80e76b34be110d922fdc4250a6e85ac77fef2338a8e33</citedby><cites>FETCH-LOGICAL-c4527-6d99d4b548560802a0ee80e76b34be110d922fdc4250a6e85ac77fef2338a8e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0194599819835779$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0194599819835779$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,1411,21798,27901,27902,43597,43598,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30857486$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oliver, Jamie</creatorcontrib><creatorcontrib>Wu, Peter</creatorcontrib><creatorcontrib>Chang, Clifford</creatorcontrib><creatorcontrib>Roden, Dylan</creatorcontrib><creatorcontrib>Wang, Binhuan</creatorcontrib><creatorcontrib>Liu, Cheng</creatorcontrib><creatorcontrib>Hu, Kenneth</creatorcontrib><creatorcontrib>Schreiber, David</creatorcontrib><creatorcontrib>Givi, Babak</creatorcontrib><title>Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck</title><title>Otolaryngology-head and neck surgery</title><addtitle>Otolaryngol Head Neck Surg</addtitle><description>Objective
Clear cell carcinoma (CCC) is a rare salivary gland malignancy, believed to be generally low grade. We investigated CCC epidemiology and clinical behavior, using the National Cancer Database (NCDB).
Study Design
Retrospective cohort study.
Setting
NCDB.
Subjects and Methods
All CCCs of the salivary glands were selected between 2004 and 2015. Patient demographics, tumor characteristics, treatments, and survival were analyzed. Cox regression analyses were performed in treated patients.
Results
We identified 268 patients with CCC. Median age was 61 (21-90) years. Most were female (145, 54%). The most common site was oral cavity (119, 44%), followed by major salivary glands (68, 25%) and oropharynx (41, 15%). Most tumors were low grade (81, 68%) and stages I to II (117, 60.6%). Nodal (36, 17.5%) and distant metastases (6, 2.4%) were rare. Most were treated by surgery alone (134, 50.0%), followed by surgery and radiotherapy (69, 25.7%). Five-year overall survival (OS) was 77.6% (95% CI, 71.4%-84.2%). In univariate analysis, older age, major salivary gland and sinonasal site, stages III to IV, high grade, and positive margins were associated with worse OS. In multivariate analysis, only high tumor grade (hazard ratio [HR], 5.76; 95% CI, 1.39-23.85; P = .02), positive margins (HR, 4.01; 95% CI, 1.20-13.43; P = .02), and age ≥60 years (HR, 3.45; 95% CI, 1.39-8.55; P = .01) were significantly associated with OS.
Conclusion
We report the largest series of clear cell carcinomas of the head and neck. Outcomes are generally favorable following surgical-based treatments. In this series, pathologic tumor grade is associated with worse survival. Routine evaluation and reporting of tumor grade might better guide physicians in recommending appropriate treatments in this rare malignancy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma - mortality</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma - therapy</subject><subject>clear cell carcinoma</subject><subject>Female</subject><subject>head and neck cancer</subject><subject>Humans</subject><subject>hyalinizing clear cell carcinoma</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Staging</subject><subject>New York City</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>salivary gland cancer</subject><subject>Salivary Gland Neoplasms - mortality</subject><subject>Salivary Gland Neoplasms - pathology</subject><subject>Salivary Gland Neoplasms - therapy</subject><subject>Survival Analysis</subject><issn>0194-5998</issn><issn>1097-6817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkL1PwzAUxC0EoqWwM6GMLAE7tmN7hIrSSlXLALPlOC-Qko9iJ0L970mawoCEmJ707nen0yF0SfANIULcYqIYV0oSJSkXQh2hMcFKhLEk4hiNezns9RE6836DMY5jIU7RiGLJBZPxGC2eTNOAq3xQZ8HUOAhMlQbrtrF1CftfAcYFUyiKXrZ5VZem_zdvEMzBpHt-Bfb9HJ1kpvBwcbgT9DJ7eJ7Ow-X6cTG9W4aW8airliqVsoQzyWMscWQwgMQg4oSyBAjBqYqiLLUs4tjEILmxQmSQRZRKI4HSCboecreu_mjBN7rMve36mQrq1uuIKMwkVZJ1KB5Q62rvHWR66_LSuJ0mWPcD6t8DdparQ3qblJD-GL4X6wA5AJ95Abt_A_V6vrqfkYgr0VnDwerNK-hN3bqqG-rvLl-RW4WJ</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Oliver, Jamie</creator><creator>Wu, Peter</creator><creator>Chang, Clifford</creator><creator>Roden, Dylan</creator><creator>Wang, Binhuan</creator><creator>Liu, Cheng</creator><creator>Hu, Kenneth</creator><creator>Schreiber, David</creator><creator>Givi, Babak</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck</title><author>Oliver, Jamie ; Wu, Peter ; Chang, Clifford ; Roden, Dylan ; Wang, Binhuan ; Liu, Cheng ; Hu, Kenneth ; Schreiber, David ; Givi, Babak</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4527-6d99d4b548560802a0ee80e76b34be110d922fdc4250a6e85ac77fef2338a8e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma - mortality</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma - therapy</topic><topic>clear cell carcinoma</topic><topic>Female</topic><topic>head and neck cancer</topic><topic>Humans</topic><topic>hyalinizing clear cell carcinoma</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Staging</topic><topic>New York City</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>salivary gland cancer</topic><topic>Salivary Gland Neoplasms - mortality</topic><topic>Salivary Gland Neoplasms - pathology</topic><topic>Salivary Gland Neoplasms - therapy</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oliver, Jamie</creatorcontrib><creatorcontrib>Wu, Peter</creatorcontrib><creatorcontrib>Chang, Clifford</creatorcontrib><creatorcontrib>Roden, Dylan</creatorcontrib><creatorcontrib>Wang, Binhuan</creatorcontrib><creatorcontrib>Liu, Cheng</creatorcontrib><creatorcontrib>Hu, Kenneth</creatorcontrib><creatorcontrib>Schreiber, David</creatorcontrib><creatorcontrib>Givi, Babak</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Otolaryngology-head and neck surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oliver, Jamie</au><au>Wu, Peter</au><au>Chang, Clifford</au><au>Roden, Dylan</au><au>Wang, Binhuan</au><au>Liu, Cheng</au><au>Hu, Kenneth</au><au>Schreiber, David</au><au>Givi, Babak</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck</atitle><jtitle>Otolaryngology-head and neck surgery</jtitle><addtitle>Otolaryngol Head Neck Surg</addtitle><date>2019-07</date><risdate>2019</risdate><volume>161</volume><issue>1</issue><spage>98</spage><epage>104</epage><pages>98-104</pages><issn>0194-5998</issn><eissn>1097-6817</eissn><abstract>Objective
Clear cell carcinoma (CCC) is a rare salivary gland malignancy, believed to be generally low grade. We investigated CCC epidemiology and clinical behavior, using the National Cancer Database (NCDB).
Study Design
Retrospective cohort study.
Setting
NCDB.
Subjects and Methods
All CCCs of the salivary glands were selected between 2004 and 2015. Patient demographics, tumor characteristics, treatments, and survival were analyzed. Cox regression analyses were performed in treated patients.
Results
We identified 268 patients with CCC. Median age was 61 (21-90) years. Most were female (145, 54%). The most common site was oral cavity (119, 44%), followed by major salivary glands (68, 25%) and oropharynx (41, 15%). Most tumors were low grade (81, 68%) and stages I to II (117, 60.6%). Nodal (36, 17.5%) and distant metastases (6, 2.4%) were rare. Most were treated by surgery alone (134, 50.0%), followed by surgery and radiotherapy (69, 25.7%). Five-year overall survival (OS) was 77.6% (95% CI, 71.4%-84.2%). In univariate analysis, older age, major salivary gland and sinonasal site, stages III to IV, high grade, and positive margins were associated with worse OS. In multivariate analysis, only high tumor grade (hazard ratio [HR], 5.76; 95% CI, 1.39-23.85; P = .02), positive margins (HR, 4.01; 95% CI, 1.20-13.43; P = .02), and age ≥60 years (HR, 3.45; 95% CI, 1.39-8.55; P = .01) were significantly associated with OS.
Conclusion
We report the largest series of clear cell carcinomas of the head and neck. Outcomes are generally favorable following surgical-based treatments. In this series, pathologic tumor grade is associated with worse survival. Routine evaluation and reporting of tumor grade might better guide physicians in recommending appropriate treatments in this rare malignancy.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>30857486</pmid><doi>10.1177/0194599819835779</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0194-5998 |
| ispartof | Otolaryngology-head and neck surgery, 2019-07, Vol.161 (1), p.98-104 |
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| source | Wiley-Blackwell Journals; MEDLINE; Sage Journals Online |
| subjects | Adult Aged Aged, 80 and over Carcinoma - mortality Carcinoma - pathology Carcinoma - therapy clear cell carcinoma Female head and neck cancer Humans hyalinizing clear cell carcinoma Male Middle Aged Neoplasm Grading Neoplasm Staging New York City Retrospective Studies Risk Factors salivary gland cancer Salivary Gland Neoplasms - mortality Salivary Gland Neoplasms - pathology Salivary Gland Neoplasms - therapy Survival Analysis |
| title | Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck |
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