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52例小涎腺腺样囊性癌的临床分析

[Clinical analysis of 52 cases of adenoid cystic carcinoma in minor salivary gland].

作者信息

Wang Jia-feng, Ge Ming-hua, Wang Ke-jing, Tan Zhuo, Chen Chao, Xu Jia-jie

机构信息

Department of Head and Neck Surgery, Zhejiang Tumor Hospitol, Hangzhou 310022, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2012 Dec;47(12):705-10. doi: 10.3760/cma.j.issn.1002-0098.2012.12.001.

Abstract

OBJECTIVE

To investigate the prognosis of adenoid cystic carcinoma (ACC) in minor salivary glands and its influencing factors.

METHODS

Clinical data of 52 patients with ACC in minor salivary glands were reviewed. The distribution of stage was as follows: stage I (6%), stage II (21%), stage III (27%) and stage IV (46%). Counting data was analyzed by χ(2) test or Fisher's exact. Survival rates were calculated by Kaplan-Merier method. Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.

RESULTS

All patients underwent primary tumor radical resection, 39 patients (75%) received postoperative radiation. The regional recurrence rate was 37% and distant metastasis rate was 21%. The 5-, 10-year cumulative local control rate were 68% and 63% respectively. The 5-, 10-year cumulative distant control rate were 86%, 68% respectively. The 5-, 10-year tumor specific survival rates were 70% and 54% respectively. Multivariate analysis showed that T stage, lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands.

CONCLUSIONS

Recurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands. T stage, lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands. Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.

摘要

目的

探讨小涎腺腺样囊性癌(ACC)的预后及其影响因素。

方法

回顾性分析52例小涎腺ACC患者的临床资料。分期分布如下:Ⅰ期(6%),Ⅱ期(21%),Ⅲ期(27%)和Ⅳ期(46%)。计数资料采用χ(2)检验或Fisher确切概率法分析。生存率采用Kaplan-Merier法计算。采用Log-rank检验评估累积生存曲线差异的统计学意义。多因素分析采用Cox比例风险模型。

结果

所有患者均接受原发肿瘤根治性切除,39例(75%)接受术后放疗。区域复发率为37%,远处转移率为21%。5年、10年累积局部控制率分别为68%和63%。5年、10年累积远处控制率分别为86%、68%。5年、10年肿瘤特异性生存率分别为70%和54%。多因素分析显示,T分期、淋巴结转移和神经周侵犯与小涎腺ACC的肿瘤特异性生存相关。

结论

复发和转移是小涎腺ACC治疗失败的主要原因。T分期、淋巴结转移和神经周侵犯是小涎腺ACC的独立预后因素。根治性手术及合理的术后放疗是主要治疗策略。

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