Histologic origin and survival in salivary duct carcinoma: A retrospective cohort study
OTO Open, 2026
Salivary duct carcinoma (SDC) is a rare and aggressive cancer that can arise either de novo or from a pre-existing benign tumor called pleomorphic adenoma, with de novo cases presenting with significantly more advanced disease (Stage IV: 61% vs 32%, p=.011; T4 tumors: 53% vs 28%, p=.040). This study analyzed 68 patients treated with curative intent to determine whether the cancers origin affects survival outcomes, finding no significant differences in overall survival (p=.28) or disease-free survival (p=.19), though patients with SDC arising from pleomorphic adenoma showed numerically higher 2-year survival rates (87% vs 81% for overall survival; 63% vs 57% for disease-free survival). Distant recurrence was the primary cause of treatment failure, occurring in 37% of de novo cases compared to 20% in those arising from pleomorphic adenoma (p=.23), with bone (14%), lung (11%), and liver (8%) being the most common sites. Pathologic lymph node involvement emerged as the only independent predictor of disease recurrence (hazard ratio 2.98, 95% CI 1.40-6.37, p=.005), highlighting the urgent need for novel systemic therapies such as neoadjuvant treatments to prevent distant spread, particularly in patients with nodal metastasis at diagnosis.
Recommended citation: Gao L, Sridhar S, Habib DRS, Aweeda M, Topf MC, Langerman A. Histologic origin and survival in salivary duct carcinoma: A retrospective cohort study. OTO Open. 2026;10(2):e70224. doi:10.1002/oto2.70224