Predictive factors and prognostic importance of limph node metastasis in salivary gland carcionomas / Fatores preditivos e importancia prognostica das metastases linfonodais em carcinomas das glandulas salivares

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Benign and malignant salivary gland neoplasias comprises 4?10% of all the neoplasias affecting humans. The parotid glands are the most commonly affected, followed by minor salivary and submandibular glands. Regional metastasis, tumor extension, presence of pain, and age older than 55 years have been considered poor prognostic indicators. The aim of this study was to analyze the clinical, histological and immunohistochemical characteristics of malignant salivary gland tumors treated at the Department of Head and Neck Surgery, A.C. Camargo Hospital, São Paulo, and to identify the risk factors associated with lymph node metastasis and its prognostic relevance. Clinical data were obtained from the medical records. Histopathological slides were reviewed and immunohistochemical reactions against p53 protein, carcinoembryonic antigen (CEA), Ki-67, c-erbB-2 and bcl-2 performed using the streptavidin-biotin-peroxidase method. Results revealed that 150 patients were men (51.2%) and 143 women (48.8%), with a mean age of 48 years, varying from 5 to 91 years. Primary tumors involving the major salivary glands were observed in 152 cases (51.9%), 120 of which affected the parotid glands. Histological analysis revealed Mucoepidermoid Carcinoma (41.6%) followed by Adenoid Cystic Carcinoma (28.7%) totaling 70.3% of the cases. Surgery was needed in most of the cases and 119 patients were submitted to neck dissection. Recurrence was observed for 104 patients (35.5%). Survival rate was 65.6% at 5 years and 54.6% at 10 years. Immunohistochemical reactions for p53, bcl-2, Ki-67, CEA, c-erbB-2 were positive in 31.2%, 46.6%, 27.1%, 19.2% and 41.0% of the cases, respectively. Clinically affected lymph nodes, p53 positive and C-erb-2 negative tumor cells, and age older than 40 years were regarded as risk factors for lymph node metastasis. Clinically affected lymph nodes, tumors 4 cm or greater in diameter, tumors with Ki-67 positive cells, and age older than 40 years were considered independent prognostic factors for death. Conclusion: limph node metastasis are associated with age, clinical identification of metastatic limph nodes and immunoexpression of p53 (positive) and C-erbB-2 (negative). Limph node metastasis is a significant and independent prognostic factor in salivary gland carcinomas

ASSUNTO(S)

parotid glands neck pescoço glandulas parotidas

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