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Salivary duct carcinoma: what is already known, and can we improve survival?

Published online by Cambridge University Press:  12 April 2012

D T H Wee*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
A A Thomas
Affiliation:
Department of Anatomical Pathology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
P J Bradley
Affiliation:
Department of Head and Neck Surgery, Nottingham University Hospitals, Queen's Medical Centre Campus, Nottingham, UK
*
Address for correspondence: Dr Desmond Tiong Hien Wee, Department of Otorhinolaryngology – Head and Neck Surgery, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, Western Australia, Australia6009 E-mail: [email protected]

Abstract

Salivary duct carcinoma is an aggressive malignancy with a high mortality rate, which phenotypically resembles high-grade breast ductal carcinoma. The parotid gland is the most common location. Standard treatment is surgery to the primary tumour together with post-operative radiotherapy. Despite this, there is a high rate of local recurrence, cervical nodal involvement and distant metastasis. Chemotherapy is currently considered only for end-stage, disseminated disease; however, current evidence indicates that chemotherapy used with radiotherapy may result in improved disease control and survival.

Human epidermal growth factor receptor-2 is a proto-oncogene which is over-expressed in both breast ductal carcinoma and salivary duct carcinoma. Clinical studies of patients with metastatic breast cancer, using trastuzumab, a monoclonal antibody directed against human epidermal growth factor receptor-2, have shown significant efficacy in tumour response, resulting in improved survival. Such advances in immunohistochemistry, and in targeted immunotherapy for breast ductal carcinoma, should be applied to the treatment of salivary duct carcinoma.

Type
Review Article
Copyright
Copyright © JLO (1984) Limited 2012

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