A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands

Eline Boon, Miranda Bel, Wim van Boxtel, Winette T. A. van der Graaf, Robert J. J. van Es, Simone E. J. Eerenstein, Robert J. Baatenburg de Jong, Michiel W. M. van den Brekel, Lilly-Ann van der Velden, Max J. H. Witjes, Ann Hoeben, Stefan M. Willems, Elisabeth Bloemena, Laura A. Smit, Sjoukje F. Oosting, Marianne A. Jonker, Uta E. Flucke, Carla M. L. van Herpen*, PALGA Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in-situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and- to a lesser extent-HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting.
Original languageEnglish
Pages (from-to)758-766
Number of pages9
JournalInternational Journal of Cancer
Issue number4
Publication statusPublished - 15 Aug 2018


  • salivary duct carcinoma
  • salivary gland neoplasms
  • androgen receptors
  • receptor
  • ErbB-2
  • prognosis
  • survival
  • in situ hybridization
  • fluorescence
  • immunohistochemistry
  • Recurrence
  • Prognosis
  • Humans
  • Middle Aged
  • Male
  • Palliative Care
  • Chemoradiotherapy, Adjuvant
  • Neoplasm Metastasis
  • Netherlands
  • Carcinoma/pathology
  • Aged, 80 and over
  • Adult
  • Female
  • Salivary Gland Neoplasms/pathology
  • Receptor, ErbB-2/metabolism
  • Salivary Ducts/pathology
  • Survival Rate
  • Factor Analysis, Statistical
  • Lymphatic Metastasis
  • Disease-Free Survival
  • Aged
  • Receptors, Androgen/metabolism

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