Carrillo José F, Vázquez Rafael, Ramírez-Ortega Margarita C, Cano Ana, Ochoa-Carrillo Francisco J, Oñate-Ocaña Luis F
Head and Neck Department, Division of Surgery, Instituto Nacional de Cancerologia, Mexico City, Mexico.
Cancer. 2007 May 15;109(10):2043-51. doi: 10.1002/cncr.22647.
Parotid gland carcinoma is an infrequent tumor, and series that report on these neoplasms are relatively scarce in the literature. The objective of the current study was to identify prognostic factors in patients with parotid gland carcinoma and to develop a method for defining the probability of recurrence.
Patients with parotid gland carcinoma who were treated at the authors' institution from January 1981 through December 2004 and who completed treatment constituted the study group. Disease-free survival was calculated by using the Kaplan-Meier method. Logistic regression analysis was employed to define the recurrence-associated prognostic factors.
One hundred twenty-seven patients were included (64 men and 63 women); their mean age was 53 years. Mucoepidermoid carcinoma was diagnosed in 34.6% of patients, adenoid cystic was diagnosed in 15.7% of patients, adenocarcinoma was diagnosed in 14.3% of patients, and acinic cell carcinoma was diagnosed in 9.4% of patients. The median disease-free survival was 8.3 years (95% confidence interval [95% CI], 4.3-12.2 years). Logistic regression analysis confirmed tumor classification, facial nerve palsy, grade of tumor differentiation, patient age, and surgical margins as recurrence-associated factors (P < .00001). Using this model, 3 postoperative risk groups were defined-high-risk, intermediate-risk, and low-risk-that had recurrence frequencies of 71.4%, 43.1%, and 8.8%, respectively (P = .0001). The 5-year disease-free survival rates for these groups were 18.7%, 53.9%, and 99.9%, respectively (P = .00001).
In this study, the authors identified several significant prognostic factors. Consequently, they have proposed a prognostic score categorization that allows for a straightforward calculation of the risk of recurrence for a given patient that may help to define therapeutic strategies, target patient counseling, and design future trials.
腮腺癌是一种罕见的肿瘤，文献中报道这类肿瘤的系列研究相对较少。本研究的目的是确定腮腺癌患者的预后因素，并开发一种确定复发概率的方法。
1981年1月至2004年12月在作者所在机构接受治疗并完成治疗的腮腺癌患者构成研究组。采用Kaplan-Meier法计算无病生存期。采用逻辑回归分析确定与复发相关的预后因素。
共纳入127例患者（64例男性和63例女性）；平均年龄为53岁。34.6%的患者诊断为黏液表皮样癌，15.7%的患者诊断为腺样囊性癌，14.3%的患者诊断为腺癌，9.4%的患者诊断为腺泡细胞癌。无病生存期的中位数为8.3年（95%置信区间[95%CI]，4.3 - 12.2年）。逻辑回归分析证实肿瘤分类、面神经麻痹、肿瘤分化程度、患者年龄和手术切缘是与复发相关的因素（P <.00001）。使用该模型，定义了3个术后风险组——高风险、中风险和低风险——复发频率分别为71.4%、43.1%和8.8%（P =.0001）。这些组的5年无病生存率分别为18.7%、53.9%和99.9%（P =.00001）。
在本研究中，作者确定了几个重要的预后因素。因此，他们提出了一种预后评分分类方法，可直接计算特定患者的复发风险，这可能有助于确定治疗策略、指导患者咨询以及设计未来试验。
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