腮腺黏液表皮样癌：影响预后的因素。
Mucoepidermoid carcinoma of the parotid gland: factors affecting outcome.
机构信息
Department of Radiation Oncology, Tata Memorial Hospital, Parel (East), Mumbai 400012, India.
出版信息
Head Neck. 2011 Apr;33(4):497-503. doi: 10.1002/hed.21477.
BACKGROUND
The purpose of this study was to identify the prognostic factors affecting the outcome in patients with mucoepidermoid carcinoma (MEC) of the parotid gland.
METHODS
A total of 113 patients with MEC who were treated between 1993 and 2002 were analyzed.
RESULTS
At median follow-up of 49 months (range, 1-143 months), disease-free survival (DFS) at 5 and 10 years was 84.6 and 84.6%, 80.7% and 67.3%, and 52.5% and 35.0% for low-grade, intermediate-grade, and high-grade tumors, respectively. Five-year and 10-year overall survival was 96.8% for low-grade tumors; 94.1% and 82.4%, respectively, for intermediate-grade tumors; and 73.3% for high-grade tumors. High-grade tumors and lymph node cancer-positive neck tumors strongly predicted poor locoregional control and DFS, while close or positive cut margins showed a trend toward poorer outcomes.
CONCLUSION
Histologic grade is the most important factor affecting outcome in parotid MEC. Adjuvant radiotherapy is recommended for high-grade tumors and should be tailored according to the expected risk of recurrence for low-grade and intermediate-grade tumors.
背景
本研究旨在确定影响腮腺黏液表皮样癌（MEC）患者预后的因素。
方法
分析了 1993 年至 2002 年间接受治疗的 113 例 MEC 患者。
结果
中位随访 49 个月（范围 1-143 个月），低级别、中级别和高级别肿瘤的 5 年和 10 年无病生存率（DFS）分别为 84.6%和 84.6%、80.7%和 67.3%、52.5%和 35.0%。低级别肿瘤的 5 年和 10 年总生存率分别为 96.8%；中级别肿瘤分别为 94.1%和 82.4%；高级别肿瘤为 73.3%。高级别肿瘤和淋巴结阳性的颈部肿瘤强烈预示着局部区域控制和 DFS 不良，而切缘接近或阳性则预示着结局较差。
结论
组织学分级是影响腮腺 MEC 患者预后的最重要因素。高级别肿瘤推荐辅助放疗，低级别和中级别肿瘤应根据复发风险进行个体化治疗。
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