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Carcinoma ex Pleomorphic Adenoma: Multi-Institutional Retrospective Cohort Study.

Bryce Kassalow1, Andrew Prince1, Martin Bullock2

  • 1Department of Otolaryngology-Head and Neck Surgery University of Michigan Ann Arbor Michigan USA.

OTO Open
|July 14, 2025
PubMed
Summary

Carcinoma ex pleomorphic adenoma (CXPA) survival rates vary. Pathologic nodal stage ≥1 is a significant predictor of death in CXPA patients, highlighting the need for targeted treatment strategies.

Keywords:
carcinoma ex pleomorphic adenomahead and necksalivary gland tumor

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Area of Science:

  • Oncology
  • Head and Neck Surgery
  • Pathology

Background:

  • Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignant tumor with variable survival outcomes reported in existing literature.
  • Understanding prognostic factors is crucial for improving patient management and outcomes.

Purpose of the Study:

  • To investigate overall survival (OS), disease-specific survival (DSS), and locoregional recurrence-free survival (LRFS) in patients with CXPA.
  • To identify clinicopathological factors associated with survival and recurrence in CXPA.

Main Methods:

  • A multi-institutional retrospective cohort study was conducted using data from Queen Elizabeth II Health Sciences Center (2006-2023) and the University of Michigan (2017-2023).
  • 37 patients with CXPA who underwent surgical resection were identified through institutional pathology and parotidectomy databases.

Main Results:

  • Most CXPA cases were locoregionally advanced (51% ≥T3, 32% node-positive).
  • The 2-year OS was 82% and 5-year OS was 61.7%. Pathologic nodal stage ≥1 was the only significant independent predictor of mortality (HR 9.474, P=.034).
  • The 2-year LRFS was 80% and 5-year LRFS was 75%. Prior adjuvant radiation did not significantly prevent locoregional recurrence.

Conclusions:

  • Metastasis to the neck in CXPA patients is associated with a poorer prognosis.
  • While surgery and adjuvant radiation are standard treatments, further research is needed to optimize prognostic factor assessment and radiation strategies for improved LRFS.