Ge Ming-hua, Wang Jia-feng, Xia Qing-min, Tan Zhuo, Xu Jia-jie, Chen Chao, Wang Ke-jing, Tan Xiang-rong
Department of Head and Neck Surgery, Zhejiang Tumor Hospital, Hangzhou 310022, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Mar;47(3):202-6.
To investigate the prognosis of adenoid cystic carcinoma (ACC) in salivary gland and its influencing factors.
Clinical and following-up data of 76 patients with ACC in salivary glands were reviewed. Major gland tumors represented 35.5% whereas minor gland tumors comprised 64.5% of the cohort, with 8 cases (10.5%) in stage I, 23 (30.3%) in stage II, 18 (23.7%) in stage III and 27(35.5%) in stage IV. Survival rates were calculated by Kaplan-Merier method. Cumulative survival curves were evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.
The regional recurrence rate was 28.9% and distant metastasis rate was 21.1%. The overall 5-year survival rate, tumor-free survival rate and tumor-related survival rate were 73.7%, 61.8% and 74.9% respectively. The overall 10-year survival rate, tumor-free survival rate and tumor-related survival rate were 48.2%, 39.8% and 56.2% respectively. Univariate survival analysis showed pathological type, clinical stage and perineural invasion were relevant to the prognosis of ACC and multivariate analysis showed they were the independent prognostic factors of ACC in salivary gland.
Clinical stage, pathological type and perineural invasion were the independent prognostic factors for adenoid cystic carcinoma in salivary gland. Surgery was the first choice for the treatment of adenoid cystic carcinoma in salivary gland, and postoperative radiotherapy may prolong the tumor-free survival time of patients in stage III and IV.
探讨涎腺腺样囊性癌（ACC）的预后及其影响因素。
回顾性分析76例涎腺ACC患者的临床及随访资料。大涎腺肿瘤占队列的35.5%，小涎腺肿瘤占64.5%，其中Ⅰ期8例（10.5%），Ⅱ期23例（30.3%），Ⅲ期18例（23.7%），Ⅳ期27例（35.5%）。采用Kaplan-Merier法计算生存率。用Log-rank检验评估累积生存曲线。通过Cox比例风险模型进行多因素分析。
区域复发率为28.9%，远处转移率为21.1%。5年总生存率、无瘤生存率和肿瘤相关生存率分别为73.7%、61.8%和74.9%。10年总生存率、无瘤生存率和肿瘤相关生存率分别为48.2%、39.8%和56.2%。单因素生存分析显示病理类型、临床分期和神经侵犯与ACC的预后相关，多因素分析显示它们是涎腺ACC的独立预后因素。
临床分期、病理类型和神经侵犯是涎腺腺样囊性癌的独立预后因素。手术是涎腺腺样囊性癌的首选治疗方法，术后放疗可延长Ⅲ期和Ⅳ期患者的无瘤生存时间。
