Japanese journal of clinical oncology最新文献

{"title":"Recurrence risk following rectal cancer surgery: a survival analysis of key predictors.","authors":"Neda Gorjizadeh, Reza Hajebi, Matin Vahedi, Mahsa Mottahedi, Elham Nazar","doi":"10.1093/jjco/hyaf080","DOIUrl":"https://doi.org/10.1093/jjco/hyaf080","url":null,"abstract":"<p><strong>Background: </strong>Identifying predictors of postsurgical recurrence in patients with rectal cancer is critical for optimizing postoperative management and improving patient outcomes. We aimed to assess the effects of demographic, clinical, and pathological factors on recurrence risk after rectal cancer surgery.</p><p><strong>Methods: </strong>We conducted a secondary analysis of data from patients who underwent curative rectal cancer surgery between 2004 and 2018. A Cox proportional hazards regression model was applied to examine the influence of variables on recurrence risk. Kaplan-Meier curves were used to visualize cumulative hazards.</p><p><strong>Results: </strong>Among 961 patients (62.7% male, mean age 63.1 years), 127 (13.2%) experienced recurrence over a median follow-up of 60 months. Based on the Cox model (C-index = 0.770, likelihood ratio test χ2(19) = 127.5, P < 0.001), significant predictors of increased recurrence risk included pathologic node stage N1 (hazard ratio 2.92, 95% CI: 1.84-4.63, P < 0.001) and N2 (4.05, 2.36-6.94, P < 0.001), as well as fewer than 12 harvested lymph nodes (1.95, 1.31-2.90, P = 0.001). Moderately differentiated histology reduced recurrence risk (0.49, 0.27-0.89, P = 0.018), and age (0.98, 0.96-0.99, P = 0.004) was inversely correlated with recurrence risk. Sex, chemotherapy, pathologic tumor stage, and lymphovascular invasion were not significant predictors of recurrence.</p><p><strong>Conclusion: </strong>This study identified key factors associated with recurrence risk after rectal cancer surgery, highlighting the importance of pathologic node stage, lymph node metrics, and histological differentiation. These findings provide a foundation for personalized postoperative management strategies and improving long-term outcomes in rectal cancer patients.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid body tumors-epidemiology and surgical resection.","authors":"Kiyoto Shiga, Katsunori Katagiri, Aya Ikeda, Daisuke Saito, Shin-Ichi Oikawa, Kodai Tshuchida, Jun Miyaguchi, Takahiro Kusaka, Akio Tamura","doi":"10.1093/jjco/hyaf074","DOIUrl":"https://doi.org/10.1093/jjco/hyaf074","url":null,"abstract":"<p><p>Carotid body tumor originates from paraganglion cells of the carotid body and is a hypervascular tumor with multiple feeding arteries and uniquely located at the carotid bifurcation. Recently, it has been revealed that various types of gene alterations exist mainly in the succinate dehydrogenase (SDH) gene family. Although resection is a radical therapy for this tumor, complete resection is challenging. On the other hand, radiotherapy for carotid body tumors is insufficient as a radical therapy concerning the response rate. Here, we reviewed articles reporting carotid body tumor treatment and surgical resection focusing on choice of treatment, surgical difficulties, and preoperative embolization of feeding arteries. The effectiveness of preoperative embolization remains controversial due to the varied situations performing surgical resection among the institutions.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized, placebo-controlled phase III trial of an autologous, formalin-fixed tumor vaccine for newly diagnosed glioblastoma: trial protocol.","authors":"Yoshihiro Muragaki, Eiichi Ishikawa, Manabu Tamura, Takakazu Kawamata, Masahiko Gosho, Koichi Hashimoto, Takashi Komori, Hideaki Yokoo, Masao Matsutani, Katsuya Maebayashi, Toshihide Tanaka, Shigeru Yamaguchi, Masayuki Kanamori, Tetsuya Yamamoto, Mitsuto Hanihara, Yoshiki Arakawa, Takashi Sasayama, Tatsuya Abe, Hideo Nakamura, Akitake Mukasa, Takeo Uzuka, Kosuke Nakajo, Tadao Ohno","doi":"10.1093/jjco/hyaf078","DOIUrl":"https://doi.org/10.1093/jjco/hyaf078","url":null,"abstract":"<p><p>This multi-institutional, double-blind, randomized, placebo-controlled phase III trial was designed to evaluate the efficacy and safety of Cellm-001, an autologous formalin-fixed brain tumor immunostimulant, for newly diagnosed glioblastoma with gross total resection to prolong overall survival (OS) and prevent recurrence after surgery. One hundred twelve patients are to be randomized 1:1 to either Cellm-001 with standard chemoradiotherapy (CRT) or saline solution with standard CRT. Randomization is based on the following stratified randomization criteria: age, Karnofsky Performance Status, and the presence or absence of photodynamic therapy (PDT). The primary endpoint is OS and secondary outcomes are progression-free survival (PFS), OS and PFS with and without radiographically residual lesions as subgroups, OS and PFS with and without PDT, p53-negative OS and PFS, high Cluster of Differentiation-8 score OS and PFS, OS associated with death in primary disease, and 24-month OS and PFS rates. All institutions received ethical committee approval and patient enrollment began in 2021.</p><p><strong>Importance of the study: </strong>Given the growing interest in immunotherapy (IMT), we developed an autologous formalin-fixed tumor vaccine (AFTV) manufactured from the patient's own glioblastoma multiforme (GBM) tissue in paraffin-embedded blocks made from the resected tumor and a double-blind, randomized phase IIB trial of AFTV with temozolomide in newly diagnosed GBM was conducted. The 3-year progression-free survival (PFS) rate for patients with gross total resection (GTR) on imaging tended toward improvement: 81% in the AFTV group versus 46% in the placebo group (P = .067). Based on these IIB results, the feasibility of conducting a phase III trial was confirmed for IIB-eligible patients with total resection. We here plan to conduct the world's first double-blind, randomized, placebo-controlled phase III trial using Cellm-001 to demonstrate autologous tumor immunostimulant efficacy. This IMT, in combination with sub-analyses (GTR, P53 status, CD8 score, and other factors) to be validated, is expected to be a breakthrough in effective standards of care for the treatment of GBM.</p><p><strong>Trial registration: </strong>Registry number: jRCT2031200153; Date of Registration: 20 /October, /2020; Date of First Patient Enrollment: 14 /January/, 2021.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PEComa-its clinical features, histopathology, and current therapy.","authors":"Yuya Izubuchi, Takaaki Tanaka","doi":"10.1093/jjco/hyaf056","DOIUrl":"https://doi.org/10.1093/jjco/hyaf056","url":null,"abstract":"<p><p>Perivascular epithelioid cell tumors (PEComas) are a rare family of mesenchymal tumors that includes angiomyolipoma, lymphangioleiomyomatosis, pulmonary clear cell \"sugar\" tumors, and PEComa-not otherwise specified. This study aimed to provide a comprehensive review of the clinical features, molecular biology, and current status of PEComa treatment. It reportedly occurs at several sites, including the uterus, kidney, liver, lung, abdominopelvic soft tissue, gastrointestinal organs, retroperitoneum, soft tissue, bone, and skin. More common in women, it occurs in young to middle-aged people. Although the disease generally follows a benign course, cases of malignant PEComa have been reported. Malignant PEComa is characterized by a large tumor size, a high mitotic rate, and the presence of necrosis and nuclear atypia. Immunohistochemically, PEComas typically express melanocytic markers such as human melanoma black 45 (HMB45) and melanoma antigen (melan-A) and muscle markers such as smooth muscle actin (α-SMA), desmin, and caldesmon. More recently, a subtype of PEComa harboring TFE3 gene rearrangement that is mutually exclusive with tuberous sclerosis complex (TSC) mutations has been identified. The identification of TFE3 gene rearrangement can help confirm the diagnosis. The distinctive features of these TFE3-rearranged PEComas include a young-age tendency, the absence of an association with tuberous sclerosis, predominant alveolar architecture and epithelioid cytology, minimal immunoreactivity for muscle markers, and strong (3+) TFE3 immunoreactivity. Surgery is the curative treatment of choice; however, there are reports of cases and randomized controlled trials showing the efficacy of mTOR inhibitors. To the best of our knowledge, there are no reports of radiation therapy's efficacy.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and validity of the Japanese version of the palliative care phase in palliative care facilities.","authors":"Hironori Ohinata, Masanori Mori, Maho Aoyama, Nao Ito, Tomoko Shigeno, Tomoya Iida, Yuko Matsumura, Hiroaki Tsukuura, Akemi Shirado Naito, Kengo Imai, Naosuke Yokomichi, Tatsuya Morita, Mitsunori Miyashita","doi":"10.1093/jjco/hyaf076","DOIUrl":"https://doi.org/10.1093/jjco/hyaf076","url":null,"abstract":"<p><strong>Background: </strong>Palliative care phase is a tool to assess five phases that reflect a patient's care needs: stable, unstable, deteriorating, terminal, and bereavement. The palliative care phase is routinely used to describe the clinical status of patients and their families. Australia has established nationwide benchmarks for comparing care services. However, the reliability of palliative care in Japan has not yet been verified. This study aimed to develop a Japanese version of the palliative care phase and examine its inter-rater reliability.</p><p><strong>Methods: </strong>This was a multicenter, cross-sectional study. Based on previous studies, two healthcare providers evaluated the single-patient phase and calculated kappa coefficients. The reliability was assessed between March 2024 and November 2024 in a palliative care facility in Japan.</p><p><strong>Results: </strong>A total of 419 phase evaluations were conducted. The inter-rater reliability was a kappa of 0.47 (95% confidence interval 0.40-0.54). Assessment disagreements were most common during the unstable and deteriorating phases (11.7%). There were no statistically significant differences in the matches or mismatches in the assessment of the adequacy of the phases (P = 0.338).</p><p><strong>Conclusion: </strong>The Japanese version of the palliative care phase was well-adapted for use in clinical palliative care. However, the concepts underlying these phases are not clearly distinguishable. In the future, we need to further educate healthcare providers and accumulate experience through on-the-job training to improve the quality of care through palliative care outcome measurements and benchmarking during the palliative care phase.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of nivolumab + ipilimumab ± chemotherapy versus pembrolizumab + chemotherapy in patients with PD-L1-negative non-small cell lung cancer (START001 PART-B): a multicenter retrospective observational study.","authors":"Yutaro Nagano, Mamoru Takahashi, Toshiyuki Sumi, Keiki Yokoo, Tatsuru Ishikawa, Osamu Honjo, Sayaka Kudo, Shun Kondo, Yusuke Tanaka, Makoto Shioya, Midori Hashimoto, Mitsuo Otsuka, Yuta Sudo, Masahiro Yanagi, Hayato Yabe, Hirotaka Nishikiori, Masami Yamazoe, Yuichiro Asai, Yasuko Fukataki, Shiro Hinotsu, Hirofumi Chiba","doi":"10.1093/jjco/hyaf073","DOIUrl":"https://doi.org/10.1093/jjco/hyaf073","url":null,"abstract":"<p><strong>Background: </strong>Programmed death ligand 1 (PD-L1) serves as a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in patients with non-small cell lung cancer (NSCLC). This study aimed to identify the most suitable first-line treatment regimen for patients with PD-L1 expression <1% (PD-L1-negative) NSCLC by comparing nivolumab plus ipilimumab (NI), NI combined with chemotherapy (NICT), and pembrolizumab and chemotherapy (PCT).</p><p><strong>Methods: </strong>We analyzed data from 141 patients with PD-L1-negative NSCLC treated with NI, NICT, or PCT at 14 Japanese institutions between December 2020 and November 2022. Propensity score analysis was employed to minimize selection bias, and Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate progression-free survival (PFS) and overall survival (OS).</p><p><strong>Results: </strong>Neither NI nor NICT demonstrated superior PFS or OS than PCT. Subgroup analyses revealed no significant differences between treatment groups across age, histological subtypes, or clinical features. Results from propensity score matching and inverse probability of treatment weighting were consistent with those observed in the overall cohort. Moreover, safety profiles showed that PCT was associated with the lowest rates of treatment discontinuation and immune-related adverse events requiring systemic corticosteroid therapy.</p><p><strong>Conclusions: </strong>In patients with PD-L1-negative NSCLC, the efficacy of NI and NICT was not superior to that of PCT. Thus, we concluded that PCT could be a favorable treatment option for this patient population.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pectoralis major muscle mass decrease after lobectomy on the prognosis of lung cancer.","authors":"Risa Kuboi, Norifumi Tsubokawa, Atsushi Kamigaichi, Nobutaka Kawamoto, Takahiro Mimae, Yoshihiro Miyata, Morihito Okada","doi":"10.1093/jjco/hyaf072","DOIUrl":"https://doi.org/10.1093/jjco/hyaf072","url":null,"abstract":"<p><strong>Background: </strong>Low preoperative skeletal muscle mass is a negative prognostic factor for non-small cell lung cancer. However, the clinical significance of postsurgical skeletal muscle loss remains unclear. We investigated the impact of a postoperative decrease in pectoralis major muscle mass on long-term outcomes.</p><p><strong>Methods: </strong>A retrospective evaluation was conducted on 460 patients with pathological stage I-II non-small cell lung cancer who underwent lobectomy. Patients were categorized into two groups based on whether they did or did not show a decrease in pectoralis major muscle mass 12 months postoperatively, using a muscle mass change rate of 0.94 as the cutoff.</p><p><strong>Results: </strong>The group showing a decrease in muscle mass (n = 126) exhibited a higher incidence of chronic obstructive pulmonary disease than the group showing no decrease in muscle mass (n = 334). The median rate of change in the muscle mass of the pectoralis major was 1.00. The median follow-up period was 42.8 months. Overall survival was significantly lower in the group showing a decrease in muscle mass than in the group showing no decrease in muscle mass (P < .001). Multivariable Cox regression analysis revealed that a decrease in pectoralis major muscle mass after surgery was an independent prognostic factor for overall survival (hazard ratio, 1.05; 95% confidence interval, 1.03-1.06; P < .001).</p><p><strong>Conclusions: </strong>A decrease in pectoralis major muscle mass following lobectomy is associated with poor prognosis in patients with non-small cell lung cancer.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High real-world incidence of hepatic dysfunction from cabozantinib plus nivolumab for Japanese patients with metastatic renal cell carcinoma.","authors":"Toshihide Horiuchi, Koichi Nishimura, Kazutaka Nakamura, Yuki Nemoto, Yudai Ishiyama, Nanaka Katsurayama, Daisuke Toki, Hirohito Kobayashi, Tsunenori Kondo","doi":"10.1093/jjco/hyaf070","DOIUrl":"https://doi.org/10.1093/jjco/hyaf070","url":null,"abstract":"<p><strong>Objective: </strong>The real-world incidence of hepatic dysfunction after combination therapy with cabozantinib plus nivolumab (CABO+NIVO) in Japanese patients with metastatic renal cell carcinoma remains undetermined; hence, this study aimed to determine the incidence of hepatotoxicity in these patients.</p><p><strong>Methods: </strong>A total of 48 patients treated with CABO+NIVO were enrolled in this study. Alanine aminotransferase (ALT) levels were used to evaluate liver dysfunction because of its liver specificity.</p><p><strong>Results: </strong>ALT elevation of any grade was found in 30 patients (63%), and grade 3 elevation was found in eight patients (17%). No grade 4 or 5 elevations were observed. Female gender and a higher body mass index were independent predictive factors for ALT elevation. All patients were managed with dose reduction or interruption of cabozantinib and concomitant use of hepatoprotective agents without high-dose corticosteroids. Of the seven patients that underwent cabozantinib rechallenge after grade 3 ALT elevation, only two (23%) required re-interruption due to repeat grade 3 ALT elevation.</p><p><strong>Conclusions: </strong>This is the first study to examine hepatic dysfunction caused by CABO+NIVO in Japanese patients. The incidence of hepatic dysfunction was higher in real-world patients than in global patients found in pivotal phase 3 trials. Cabozantinib appeared to be a major cause of hepatic dysfunction since dose reduction or interruption of cabozantinib without the use of corticosteroids resolved hepatotoxicity. In addition, additional care should be taken when treating female or obese patients with CABO+NIVO.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-infrared photoimmunotherapy: basics and clinical application.","authors":"Ryuhei Okada, Takahiro Asakage","doi":"10.1093/jjco/hyaf069","DOIUrl":"https://doi.org/10.1093/jjco/hyaf069","url":null,"abstract":"<p><p>Use of antibody-drug conjugates (ADCs) is rapidly increasing in the field of oncology. While ADCs exhibit strong and cell-selective cytotoxicity, they do not show spatial selectivity. Near-infrared photoimmunotherapy (NIR-PIT, Alluminox™) utilizes photoactivatable ADCs, that is, antibody-photoabsorber conjugates (APCs). The photoabsorber used in NIR-PIT, IRDye700DX (IR700), is activated by light of ~690 nm wavelength. APCs, usually administered by intravenous injection, bind to the target cell surface, and subsequent excitation-light illumination dramatically changes the status of IR700 from hydrophilic to hydrophobic, inducing aggregation of the APC-target molecule complex and cell burst. Dying cells release neoantigens as well as damage-associated molecular patterns, resulting in immunogenic cell death (ICD). Based on the favorable results of clinical trials, epidermal growth factor-targeted NIR-PIT has been performed in Japan since 2021 for patients with unresectable head and neck cancers (HNCs). Since pain and local edema are frequent adverse events (AEs), various measures have been taken against these AEs. Because NIR-PIT induces ICD, combining NIR-PIT with immune checkpoint inhibitor (ICI) therapy is thought to be a rather effective strategy. NIR-PIT could also locally destroy immune suppressor cells, such as regulatory T cells, in the tumor microenvironment. Currently, numerous clinical trials are under way to evaluate the efficacy of NIR-PIT as well as of combined NIR-PIT plus ICI therapy. In this review article, we describe the basics of NIT-PIT, results of translational experiments, current clinical application of NIT-PIT in HNCs, and relevant ongoing clinical trials.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes and failure patterns in postoperative radiotherapy for major salivary gland carcinoma.","authors":"Shota Miyoshi, Ikuno Nishibuchi, Hiroki Ochi, Hiroshi Sakauchi, Shigeyuki Tani, Tsuyoshi Katsuta, Nobuki Imano, Junichi Hirokawa, Takao Hamamoto, Tsutomu Ueda, Yuji Murakami","doi":"10.1093/jjco/hyaf068","DOIUrl":"https://doi.org/10.1093/jjco/hyaf068","url":null,"abstract":"<p><strong>Objective: </strong>Surgery is the standard of care for major salivary gland carcinoma (MSGC), and postoperative radiotherapy (PORT) is used for patients at high risk of postoperative recurrence.</p><p><strong>Methods: </strong>We retrospectively analyzed 32 patients with MSGC treated with PORT between 2010 and 2019. All patients had one or more of the following high-risk factors for recurrence: histologically high-grade, T3-4 tumors, positive or close margins, lymph node (LN) metastasis, and perineural invasion.</p><p><strong>Results: </strong>The median age of the patients was 63 years (range, 18-81 years). Stage I, II, III, and IV disease were observed in 2, 5, 7, and 18 patients, respectively. Twenty-two patients underwent concurrent systemic therapy. The most commonly irradiated areas were the primary lesion and ipsilateral neck (78%). The 5-year overall survival (OS), recurrence-free survival (RFS) and locoregional control rates were 49%, 31%, and 77%, respectively. The 5-year OS rates were 86% for Stages I-III, and 22% for Stage IV. The 5-year RFS rates were 57% for Stages I-III, and 11% for Stage IV. Recurrence occurred in 22 patients. The most common pattern of recurrence was pulmonary metastases (34%). There were seven cases of cervical LN metastasis at the time of first recurrence, and five of these cases showed cervical LN metastases outside the irradiated area.</p><p><strong>Conclusions: </strong>We reported the results of PORT in patients with MSGC. Although the incidence of in-field recurrence was low, recurrence from outside the irradiated area was common, suggesting the need for further investigation into the optimal systemic therapy and radiation extent.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}