Lymphoepithelial Carcinoma of the Salivary Gland: A Systematic Review and Single Institution Experience.

Abstract

Lymphoepithelial carcinoma of the salivary gland (LECSG) is a rare malignancy. The purpose of this study is to evaluate the clinical features of LECSG with a focus on the role of Epstein-Barr virus (EBV). PubMed, Embase, Web of Science, institutional pathology Natural Language search tool. Retrospective review of patients diagnosed with LECSG at a single institution and a systematic literature review. Full text articles in English were included. 285 cases of LECSG identified via literature review and an additional 10 within our institution. Most tumors were in the parotid gland (70.5%). Lymph node metastasis was observed in 28%. Most cases were in Asian or Inuit patients (70.5%). EBV association was positive in 52%, and 87.6% of these were in endemic populations. Treatment primarily involved surgical resection (65.8%), often combined with adjuvant therapy (50.2%). No significant differences in disease-free survival (DFS) or disease-specific survival (DSS) were observed by EBV status. Advanced tumor stage was associated with worse DFS (P < .0001) and worse DSS (P < .0001). Lymph node metastasis was also associated with reduced DSS (P = .04). Independent predictors of poorer DFS and DSS included late tumor and endemic region of origin. This comprehensive analysis of 295 salivary gland LEC cases provides valuable insights into the clinical behavior, pathological features, and treatment outcomes of this rare malignancy. The study highlights the potential role of EBV in tumor pathogenesis, particularly in endemic populations, and emphasizes the need for further research to establish optimal management strategies.