Witt R L
Department of Surgery, Medical Center of Delaware, Wilmington.
Ear Nose Throat J. 1991 Apr;70(4):218-22.
Management of minor salivary gland adenoid cystic carcinoma is a controversial problem. Few clinicians obtain adequate experience in the treatment of this disease, which is often frustrated by early and late distant metastases. Fourteen cases of minor salivary gland adenoid cystic carcinoma recorded in the Delaware Registry over a 20-year period (1968 to 1988) were reviewed retrospectively. These cases were evaluated for their duration of symptoms; size, location, and histologic subtype of the lesion; perineural invasion; lymph node metastases; and treatment to determine the relationship of these factors to survival. Location and histologic subtype of the lesion and duration of symptoms were found to have a more significant impact on survival than size of the lesion, perineural invasion, or lymph node metastases. Surgery is the mainstay of therapy for minor salivary gland adenoid cystic carcinoma, with resection that includes disease-free margins but spares function being advocated. Although adjunctive radiation therapy has not been shown to increase survival, it is reasonable in lesions with perineural invasion and/or lymph node metastases.
小涎腺腺样囊性癌的治疗是一个存在争议的问题。很少有临床医生在治疗这种疾病方面积累足够的经验，早期和晚期远处转移常常使治疗受挫。回顾性分析了特拉华登记处20年间（1968年至1988年）记录的14例小涎腺腺样囊性癌病例。对这些病例的症状持续时间、病变的大小、位置和组织学亚型、神经周围侵犯、淋巴结转移以及治疗情况进行评估，以确定这些因素与生存的关系。发现病变的位置、组织学亚型和症状持续时间对生存的影响比病变大小、神经周围侵犯或淋巴结转移更为显著。手术是小涎腺腺样囊性癌治疗的主要手段，主张进行包括切缘无病但保留功能的切除。虽然辅助放疗尚未显示能提高生存率，但对于有神经周围侵犯和/或淋巴结转移的病变，放疗是合理的。
