Affiliation:
1. Faculty of Medicine and Health University of Sydney Westmead New South Wales Australia
2. St Vincent's Hospital Melbourne Fitzroy Victoria Australia
3. Peter MacCallum Cancer Centre Melbourne Victoria Australia
4. Department of Otolaryngology – Head and Neck Surgery Westmead Hospital, New South Wales Westmead New South Wales Australia
5. Department of Otolaryngology – Head and Neck Surgery John Hunter Hospital Sydney New South Wales Australia
6. Department of Radiation Oncology Crown Princess Mary Cancer Centre, Westmead Hospital Westmead New South Wales Australia
7. Macquarie University Hospital, Macquarie University New South Wales Australia
8. Chris O'Brien Lifehouse Camperdown New South Wales Australia
9. Department of Otolaryngology – Head and Neck Surgery University College London Hospitals NHS Foundation Trust London UK
10. Division of Surgery and Interventional Science University College London London UK
Abstract
ObjectiveCarcinoma ex pleomorphic adenoma (CXPA) is a rare malignant salivary gland tumor. Although multiple reviews have been published on salivary gland malignancies, it has been a decade since the last dedicated systematic review pertaining to CXPA alone was published. This study examines molecular factors in CXPA diagnosis.Data SourcesMEDLINE, CINAHL, Embase, Scopus, Web of Science (BIOSIS), Cochrane CENTRAL, Health Collection (Informit), OpenDOAR, and GreyNet International.Review MethodsSystematic review and meta‐analysis from inception to October 31, 2022 for all English language studies pertaining to “carcinoma ex pleomorphic adenoma.” Predicted incidence of each biomarker was calculated with meta‐analysis. Comparison against pleomorphic adenoma (PA) and salivary duct carcinoma (SDC) when reported within the same study are performed. Risk of bias performed with JBI tool for prevalence studies.ResultsOf 19151 unique studies undergoing abstract screening, 55 studies (n = 1322 patients) underwent data analysis. Biomarkers with >3 studies were p53, HER2, AR, EGFR, PLAG1, ERBB, ER, PR, HMGA2, p16, p63, a‐SMA, RAS, PTEN, PDL1, BRAF, PIK3CA, and c‐kit. Highest incidence was seen in AR, EGFR, p16, and p53. Significant differences were demonstrated compared with PA and SDC. There was high heterogeneity and overall high risk of bias within studies.ConclusionMolecular factors are an area of interest in the diagnosis of CXPA. Our study results support examining CXPA as a discrete cohort in future targeted therapy trials. Laryngoscope, 2023