Godballe Christian, Schultz Joyce H, Krogdahl Annelise, Møller-Grøntved Agot, Johansen Jørgen
Department of Otolarynology-Head and Neck Surgery, Odense University Hospital, Denmark.
Laryngoscope. 2003 Aug;113(8):1411-7. doi: 10.1097/00005537-200308000-00028.
To analyze clinical data and possible prognostic factors of patients with primary carcinoma of the parotid gland.
A retrospective study was made of 85 patients with suspected parotid cancer who were admitted to the Center of Head and Neck Oncology at Odense University Hospital (Odense, Denmark) from 1975 to 1994.
Patient records were retrospectively reviewed and tabulated for relevant clinical parameters. A complete revision of histological examination was performed by the same pathologist and the tumors were classified according to the 1991 international guidelines from the World Health Organization. Five tumors (6%) did not fulfill the criteria of malignancy and were reclassified as benign. In another five cases the assumed primary parotid carcinomas were found to be metastatic disease from cancers of the breast, prostate, skin, and lungs. Ten patients (12%) were excluded from the analysis, leaving 75 individuals for the study.
Twenty-four percent of patients were classified as T1, 32% as T2, 15% as T3, and 28% as T4. One patient (1%) was not classifiable (TX). Regional lymph node metastases were found in 17 cases (23%). Two of these were classified as N1 (3%), 2 as N2A (3%) and 13 as N2B (17%). Four patients were registered as not classifiable (NX) (5%). No patients were classified as N3. Distant metastases were found in four patients (5%) (one patient had bone and liver metastases and three patients had lung metastases). Five-year recurrence-free survival of the entire study group was 63%, disease-specific survival was 69%, and crude survival was 52%. In univariate analysis, tumor size, histological appearance, T status, stage, the presence of lymph node metastases, distant metastases, pain, and facial nerve dysfunction had a significant influence on survival.
A thorough histological revision is pivotal in retrospective parotid carcinoma studies, and tumor size; histological appearance; T, N, and M status; stage; facial nerve dysfunction; and pain from the face and/or neck seem to be significant prognostic indicators for patients with primary parotid carcinoma.
分析腮腺原发性癌患者的临床资料及可能的预后因素。
对1975年至1994年入住丹麦欧登塞大学医院头颈肿瘤中心的85例疑似腮腺癌患者进行回顾性研究。
对患者记录进行回顾性审查，并将相关临床参数制成表格。由同一位病理学家对组织学检查进行全面复查，并根据世界卫生组织1991年的国际指南对肿瘤进行分类。5例肿瘤（6%）不符合恶性标准，重新分类为良性。另外5例患者中，假定的原发性腮腺癌被发现是来自乳腺、前列腺、皮肤和肺部癌症的转移瘤。10例患者（12%）被排除在分析之外，剩余75例患者用于研究。
24%的患者被分类为T1，32%为T2，15%为T3，28%为T4。1例患者（1%）无法分类（TX）。17例患者（23%）发现区域淋巴结转移。其中2例被分类为N1（3%），2例为N2A（3%），13例为N2B（17%）。4例患者登记为无法分类（NX）（5%）。无患者被分类为N3。4例患者（5%）发现远处转移（1例患者有骨和肝转移，3例患者有肺转移）。整个研究组的5年无复发生存率为63%，疾病特异性生存率为69%，总生存率为52%。在单因素分析中，肿瘤大小、组织学表现、T分期、阶段、淋巴结转移的存在、远处转移、疼痛和面神经功能障碍对生存率有显著影响。
在回顾性腮腺癌研究中，全面的组织学复查至关重要，肿瘤大小、组织学表现、T、N和M分期、阶段、面神经功能障碍以及面部和/或颈部疼痛似乎是腮腺原发性癌患者重要的预后指标。
