Klinische und molekulare Epidemiologie maligner Speicheldrüsentumore

Zusammenfassung

Speicheldrüsenkarzinome sind eine seltene und heterogene Gruppe von bösartigen Tumoren, die 3–6% aller bösartigen Tumoren im Kopf-Hals-Bereich ausmachen. Die 1-, 3- und 5-Jahres-Überlebensraten liegen bei 83%, 69% bzw. 63%. Aufgrund immer neuer molekularpathologischer und genetischer Erkenntnisse werden im Rahmen der wiederkehrenden WHO-Klassifikation der Speicheldrüsenkarzinome stetig neue Entitäten definiert, sodass die Inzidenzraten der Entitäten einem ständigen Wandel unterliegen. Der einzige gesicherte Risikofaktor für die Entstehung von Speicheldrüsenkarzinomen ist ionisierende Strahlung. Darüber hinaus verschlechtern große Tumoren, zervikaler Lymphknotenbefall und Perineuralscheidenbefall die Prognose signifikant. Heute rückt die Molekularpathologie in den Vordergrund, mit der potenzielle Targets identifiziert werden konnten, die insbesondere in rezidivierten oder fernmetastasierten Stadien prognoseverbessernde Therapieoptionen bieten können. So können entitätsspezifische Tyrosinkinase-Inhibitoren wie Axitinib beim Adenoidzystischen Karzinom oder Larotrectinib beim sekretorischen Karzinom und entitätsübergreifende Therapien wie HER2-Inhibition und Androgendeprivation bei günstigem Nebenwirkungsprofil das mediane und progressionsfreie Überleben verlängern.

Abstract

Salivary gland carcinomas are a rare and heterogeneous group of malignant tumors, accounting for 3–6% of all malignant tumors in the head and neck region. The 1-, 3- and 5-year survival rates are 83%, 69% and 63% respectively. Due to new molecular pathological and genetic findings, new entities are constantly being defined as part of the recurring WHO classification of salivary gland carcinomas, so that the incidence rates of the entities are subject to constant change. The only certain risk factor for the development of salivary gland carcinomas is ionizing radiation. In addition, large tumors, cervical lymph node involvement and perineural sheath involvement significantly worsen the prognosis. Today, molecular pathology is coming to the fore, with which potential targets have been identified that can offer prognosis-improving treatment options, particularly in recurrent or distant metastatic stages. Entity-specific tyrosine kinase inhibitors such as axitinib in adenoid cystic carcinoma or larotrectinib in secretory carcinoma and cross-entity therapies such as HER2 inhibition and androgen deprivation can prolong median and progression-free survival with a favorable side effect profile.

Schlüsselwörter

Speicheldrüsenkarzinom - Kopf-Hals-Onkologie - Prognosefaktoren - Gesamtüberleben - Parotismalignom

Keywords

Head and Neck Cancer - Salivary Gland Cancer - Oncology

Publication History

Received: 20 October 2023

Accepted after revision: 27 August 2024

Article published online:
17 October 2024

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