Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan, Italy.
Oral Oncol. 2009 Aug;45(8):669-74. doi: 10.1016/j.oraloncology.2008.10.010. Epub 2008 Dec 17.
Adenoid cystic carcinoma (ACC) of salivary gland origin is rare. The EUROCARE data provide a good opportunity to study the survival of this uncommon cancer in a large population. A total of 2611 cases, aged 15 to 99 years, diagnosed between 1983 and 1994 with primary salivary gland ACC were analyzed. Thirty-two population based cancer registries from seventeen countries participating in EUROCARE contributed the data. Relative survival by sex, age, period of diagnosis, region, site and stage, and the adjusted relative excess risk (RER) of death were estimated. Survival since diagnosis was 94%, 78% and 65% at 1, 5 and ten years, respectively. Ten-year survival was best (69%) in patients of the youngest age group (15-54 years) and from Northern Europe (69%). In the UK was higher (65%) than in Western (62%) and Eastern (56%) Europe. ACCs in nasal cavity (RER 2.6), pharynx (RER 3.5) and larynx and bronchus (RER 3.9) had a worse prognosis compared to those of oral cavity. A strong effect of stage at diagnosis on RERs and some worsening of survival at five years over time (80% in 1983-1985, 76% in 1992-1994) were also evident. The findings of the present study, as those from clinical studies, confirm the important impact of primary site and stage at diagnosis on survival. Furthermore, we could demonstrate that survival for ACC did not improve over time and that cases from Eastern countries had a significant worse prognosis. Improvements in the disease detection in its early stage and international collaborative research should be encouraged.
涎腺腺样囊性癌(ACC)较为罕见。EUROCARE 数据为研究这种罕见癌症在大人群中的生存情况提供了良好的机会。共分析了 1983 年至 1994 年间诊断的 2611 例年龄在 15 至 99 岁的原发性涎腺 ACC 患者。来自 EUROCARE 的 17 个国家的 32 个基于人群的癌症登记处提供了数据。按性别、年龄、诊断时期、地区、部位和分期估计了相对生存率以及调整后的相对超额死亡风险(RER)。诊断后 1、5 和 10 年的生存率分别为 94%、78%和 65%。年龄最小组(15-54 岁)和北欧(69%)的 10 年生存率最高(69%)。英国的生存率(65%)高于西欧(62%)和东欧(56%)。鼻腔(RER 2.6)、咽(RER 3.5)和喉与支气管(RER 3.9)的 ACC 预后较差,与口腔的 ACC 相比。诊断时分期对 RER 的影响很大,而且五年生存率随时间的推移也有所恶化(1983-1985 年为 80%,1992-1994 年为 76%)。本研究的结果与临床研究的结果一致,证实了原发部位和诊断时分期对生存的重要影响。此外,我们还证明,ACC 的生存率并未随时间改善,而且来自东欧国家的病例预后明显较差。应鼓励提高疾病早期检测水平并开展国际合作研究。