Bhattacharyya Neil, Fried Marvin P
Division of Otolaryngology, Brigham & Women's Hospital, Boston, MA 02115, USA.
Am J Otolaryngol. 2005 Jan-Feb;26(1):39-44. doi: 10.1016/j.amjoto.2004.06.017.
To determine survival and factors influencing survival for parotid gland cancer.
Cases of parotid gland malignancy were extracted from the SEER database for 1988 to 1998. Kaplan-Meier survival analysis was conducted for the most common tumor histologies. Cox proportional hazards modeling was conducted to determine the influence of age, gender, histopathology, grade, size, regional modal status, extraglandular extension, and radiation therapy on survival. Subset analysis was conducted for mucoepidermoid carcinoma according to grade.
Nine hundred three patients were identified with a mean age of 59.2 years. Mean follow-up was 51.8 months. Mean 5-year and 10-year actuarial survivals for the entire cohort were 87.8 months, 66.6% and 49.7%, respectively. Mean tumor size at diagnosis was 2.7 cm; 38.0% of patients had extraglandular extension of the tumor, 26.8% of patients had positive nodal disease, and 59.4% of patients received radiation therapy. Tumor histology did predict survival, with squamous cell carcinoma and acinar cell carcinoma exhibiting the poorest and best survivals, respectively. Stratified Cox proportional hazards modeling revealed that increasing age, tumor size, grade, extraglandular extension, and nodal positivity significantly negatively influenced survival (all P<or=.001); radiation therapy conferred a survival benefit (P=.090), whereas gender did not significantly affect survival. Increasing tumor grade, nodal disease, and extraglandular extension carried particularly high hazards ratios.
Survival in parotid gland malignancy is influenced by multiple factors. Patients with multiple poor prognostic features such as extraglandular extension, aggressive tumor histologies, and nodal disease will exhibit poorer survivals and may be candidates for more aggressive treatment protocols.
确定腮腺癌的生存率及影响生存率的因素。
从监测、流行病学与最终结果（SEER）数据库中提取1988年至1998年的腮腺恶性肿瘤病例。对最常见的肿瘤组织学类型进行Kaplan-Meier生存分析。进行Cox比例风险建模以确定年龄、性别、组织病理学、分级、大小、区域淋巴结状态、腺外扩展和放射治疗对生存率的影响。根据分级对黏液表皮样癌进行亚组分析。
共识别出903例患者，平均年龄59.2岁。平均随访时间为51.8个月。整个队列的平均5年和10年精算生存率分别为87.8个月、66.6%和49.7%。诊断时肿瘤平均大小为2.7 cm；38.0%的患者肿瘤有腺外扩展，26.8%的患者有阳性淋巴结疾病，59.4%的患者接受了放射治疗。肿瘤组织学确实可预测生存率，鳞状细胞癌和腺泡细胞癌的生存率分别最差和最佳。分层Cox比例风险建模显示，年龄增加、肿瘤大小、分级、腺外扩展和淋巴结阳性对生存率有显著负面影响（均P≤0.001）；放射治疗可带来生存获益（P = 0.090），而性别对生存率无显著影响。肿瘤分级增加、淋巴结疾病和腺外扩展的风险比特别高。
腮腺恶性肿瘤的生存率受多种因素影响。具有腺外扩展、侵袭性肿瘤组织学类型和淋巴结疾病等多种不良预后特征的患者生存率较差，可能适合更积极的治疗方案。
