(A226) Management of Salivary Gland Tumors: A 20-Year SEER Database Analysis

Introduction: Salivary gland tumors represent a diverse group of neoplasms that vary in management. In light of advancing science and evolving treatment guidelines, this study assessed trends in therapeutic approach to these cancers, which is pivotal to optimizing patient outcomes, personalizing care, and ensuring evidence-based practices are implemented to improve survival rates and quality of life.

Methods: This analysis utilized case data from the Surveillance, Epidemiology, and End Results (SEER) database (N=21,579). Malignant tumors diagnosed between 2000 and 2021 were categorized by treatment: surgery alone, radiation alone, chemotherapy alone, or combinations of surgery, radiation, and chemotherapy. The staging of salivary gland neoplasms was also analyzed and categorized as local, regional, or distant. JoinPoint Regression was used to assess trends in treatment strategies and staging.

Results: The most common treatment modalities over the study period were surgery alone (40%) and a combination of surgery and radiation (40%); however, there has been a significant increase in the use of newer treatment approaches, including chemotherapy alone (5.80% annual percent change [APC], p<.05), surgery/chemotherapy/radiation (3.58% APC, p<.05), chemotherapy/radiation (2.66% APC, p<.05), and radiation alone (1.85% APC, p<.05). Increases in localized (1.72 APC, p<.05) and regional (3.88 APC, p<.05) neoplasms were also seen.

Conclusions: Surgery remains a cornerstone in the treatment of malignant salivary gland tumors; however, the use of combined modalities incorporating chemotherapy and radiation is increasing. This rise may be attributed to advancements in chemotherapy and radiation techniques, improved understanding of tumor pathophysiology, shifts in the presentation of regional and distant metastases as reflected in SEER data, and a growing focus on personalized, multidisciplinary treatment strategies. Understanding these trends is essential for enhancing outcomes in malignant salivary gland tumors.