Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Head Neck. 2011 Mar;33(3):318-23. doi: 10.1002/hed.21444. Epub 2011 Jan 31.
This study was designed to identify the factors associated with the outcome after standard treatment with surgery and postoperative radiotherapy (RT) for locally advanced salivary gland cancers.
We conducted a retrospective review of patients with salivary gland cancers registered in the University of Pittsburgh databases from 1990 to 2006.
A total of 74 patients were analyzed. Histologic types included salivary duct carcinoma, 24%; adenoid cystic carcinoma, 23%; and adenocarcinoma, 19%; N2, 39%; N0-1, 58%; and major salivary gland origin, 80%. With a median follow-up of 4.1 years, the 5-year recurrence-free survival (RFS) was 49%, and the 5-year overall survival (OS) was 55%. The 5-year local RFS was 76% and the 5-year distant RFS was 60%. Using Cox-regression analysis, advanced N classification (N2) was the only significant predictor of both RFS and OS.
The long-term survival of patients with high-risk, locally advanced salivary gland cancers is unsatisfactory. Advanced nodal disease is strongly associated with patient outcome and should be considered as a stratification factor in future trials in locally advanced salivary gland cancers.
本研究旨在确定与接受手术和术后放疗（RT）标准治疗后局部晚期涎腺癌结局相关的因素。
我们对 1990 年至 2006 年期间在匹兹堡大学数据库中登记的涎腺癌患者进行了回顾性分析。
共分析了 74 例患者。组织学类型包括涎管癌 24%、腺样囊性癌 23%、腺癌 19%、N2 39%、N0-1 58%和主要涎腺起源 80%。中位随访时间为 4.1 年，5 年无复发生存率（RFS）为 49%，5 年总生存率（OS）为 55%。5 年局部 RFS 为 76%，5 年远处 RFS 为 60%。使用 Cox 回归分析，高级 N 分类（N2）是 RFS 和 OS 的唯一显著预测因素。
高危、局部晚期涎腺癌患者的长期生存情况并不理想。晚期淋巴结疾病与患者预后密切相关，应在局部晚期涎腺癌的未来临床试验中作为分层因素加以考虑。
