Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Cancer. 2012 Aug 15;118(16):3945-53. doi: 10.1002/cncr.26740. Epub 2011 Dec 16.
The scientific literature to date lacks population-based studies on the demographics, clinical features, and survival of patients with adenoid cystic carcinoma (ACC) of different anatomic sites.
The authors identified 5349 patients who had ACC of the major salivary glands (N = 1850), minor salivary glands (N = 2077), breast (N = 696), skin (N = 291), lung and bronchus (N = 203), female genital system (N = 132), and eye and orbit (N = 100) from the Surveillance, Epidemiology, and End Results (SEER) registry. Differences in demographics, clinical features, and survival of patients were assessed.
ACC of the eye and orbit was associated with younger age at presentation (mean age,49.9 years). ACC of the skin or breast tended to present with less aggressive prognostic features, whereas ACC of the lung and bronchus or eye and orbit tended to present with more aggressive prognostic features. In a multivariate survival analysis of patients who presented with localized disease, patients with ACC of the breast (hazard ratio [HR], 0.40) or skin (HR, 0.40) had a significantly lower risk death than patients with ACC of the major salivary glands; whereas patients with ACC of the lung and bronchus (HR, 3.72) or the eye and orbit (HR, 3.67) had a significantly higher risk. For patients who presented with regional disease, the only clear prognostic difference in multivariate analysis was that patients with ACC of skin fared significantly better.
The demographics and clinical features of patients with ACC differ by disease site. The current results indicated that site may be an important predictor of survival for patients who present with localized disease but is less important for patients who present with regional disease.
目前的科学文献缺乏关于不同解剖部位的腺样囊性癌(ACC)患者的人口统计学、临床特征和生存情况的基于人群的研究。
作者从监测、流行病学和最终结果(SEER)登记处确定了 5349 名患有主要唾液腺(N=1850)、小唾液腺(N=2077)、乳房(N=696)、皮肤(N=291)、肺和支气管(N=203)、女性生殖系统(N=132)和眼部和眼眶(N=100)的 ACC 患者。评估了患者的人口统计学、临床特征和生存差异。
眼部和眼眶的 ACC 与发病时的年龄较小有关(平均年龄为 49.9 岁)。皮肤或乳房的 ACC 往往表现出不太具侵袭性的预后特征,而肺和支气管或眼部和眼眶的 ACC 往往表现出更具侵袭性的预后特征。在局部疾病患者的多变量生存分析中,患有乳房(危险比[HR],0.40)或皮肤(HR,0.40)ACC 的患者死亡风险明显低于患有主要唾液腺的患者;而患有肺和支气管(HR,3.72)或眼部和眼眶(HR,3.67)的患者死亡风险明显更高。对于患有区域性疾病的患者,多变量分析中唯一明显的预后差异是皮肤 ACC 患者的预后明显更好。
患者的人口统计学和临床特征因疾病部位而异。目前的结果表明,部位可能是局部疾病患者生存的重要预测因素,但对于局部疾病患者则不太重要。