Adenocarcinoma of salivary origin. Clinicopathologic study of 204 patients

We have reviewed a 30 year experience with 204 patients treated for adenocarcinomas of salivary origin. Seventy-one percent had histologically typical adenocarcinomas, whereas 12 percent had papillary, 12 percent mucinous, and 5 percent other unusual variants. Despite these morphologic differences, almost all of the lesions could be classified into one of three histologic grades. The tumors arose most often in the minor salivary glands (138 patients, 68 percent) and the less common variants of adenocarcinoma usually involved the oral cavity, nasal cavity, or paranasal sinuses. High-grade tumors were more often high stage at the time of diagnosis. Treatment almost always consisted of surgical resection which was tailored according to the site and extent of the lesion. Five, 10, and 15 year cure rates were 41, 34, and 28 percent, respectively, and salvage was determined by the grade and stage of the tumor rather than by the extent of the surgery. Local recurrence of this most lethal of salivary tumors exceeded 50 percent. Postoperative teletherapy is probably indicated in most patients if survival rates are to increase, but the role of systemic chemotherapy remains to be defined.