Clinical Paper
Head and Neck Oncolgogy
Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population

https://doi.org/10.1016/j.ijom.2009.10.016Get rights and content

Abstract

There is little information in the English-language literature about the epidemiology of salivary gland neoplasms in the eastern Chinese population. A large retrospective study (6982 primary salivary tumors during 23 years) was carried out to investigate the clinicopathological features (tumor location, patient sex and age) of these tumors in this population. 3593 tumors were in males and 3389 in females. Pleomorphic adenoma (69%) was the most common tumor and 20% were located in minor glands. 92% of Warthin's tumors occurred in males. Malignant tumors were predominantly adenoid cystic carcinoma (30%) and mucoepidermoid carcinoma (30%). Incidences of lymphoepithelial carcinomas (5%) and polymorphous low-grade adenocarcinoma (1%) of malignant tumors were identified. 28% of tumors originated from minor glands. Most findings were similar to those in the literature, with some variations. The salivary tumors slightly predominated in males. Relatively higher incidences of minor gland tumors and specifically of pleomorphic adenoma in minor glands were noted. Adenoid cystic carcinoma and mucoepidermoid carcinoma constituted the most common malignancies. There was a high incidence of lymphoepithelial carcinomas but a low incidence of polymorphous low-grade adenocarcinoma. The historical significant male predominance of Warthin's tumor was confirmed.

Section snippets

Patients and Methods

This study included patients with primary epithelial salivary gland neoplasms who, during the 23-year period between 1985 and 2007, underwent operations in the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine in the east of China.

Hematoxylin-eosin stained slides (and immunostained sections if necessary) of all cases were reviewed and reclassified by three pathologists based on the World Health Organization (WHO) Pathology

Histological Types

6982 patients underwent operations for salivary gland tumors during the specified period. Of these tumors, 4743 (68%) were benign and 2239 (32%) were malignant. The ratio of benign tumors to malignancies was 2.12:1. The distribution of histological patterns by anatomical locations for benign and malignant salivary tumors are shown in Table 1, Table 2, respectively.

Pleomorphic adenoma (PA) was the most common tumor and accounted for 69% (3281/4743) of all benign tumors, followed by Warthin's

Discussion

Shanghai Ninth People's Hospital is one of the largest comprehensive hospitals in China and is the care center for oral and maxillofacial tumors in the east of China. Many more patients with salivary gland tumors are treated in this hospital than in any other hospital in China. This setting provided an excellent population in which to evaluate the clinicopathological features of these tumors.

The WHO classification of salivary gland tumors, which has had three editions, has been employed in

Funding

Chinese Nature Science Foundation (grant 30672328) and Shanghai Leading Academic Discipline Project (S30206)

Competing Interests

None

Ethical Approval

Not required

Acknowledgement

The authors thank Sunita Patterson from Dept. of Scientific Publications, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA for the English editing of this manuscript.

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    This work was supported by Chinese Nature Science Foundation (grant 30672328) and Shanghai Leading Academic Discipline Project (S30206).

    1

    Zhen Tian and Lei Li contributed equally to this work.

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