Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2013 Jul;20(7):2396-404. doi: 10.1245/s10434-013-2872-2. Epub 2013 Feb 9.
The objective of this study was to determine the incidence and cause of disease-specific death in patients with mucoepidermoid carcinoma (MEC) affecting the major salivary glands.
A total of 94 patients with MEC treated at Memorial Sloan-Kettering Cancer Center between 1985 and 2009 were identified from a preexisting database of 451 patients with major salivary gland cancer. Patient, tumor, and treatment characteristics were recorded from a retrospective analysis of patient charts. There were 49 males (52 %), and the median age was 57 years (range, 9-89 years). Of the 94 patients, 49 % had low, 22 % had intermediate, and 28 % had high-grade carcinoma. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. Cause of death was determined by chart review. Predictors of DSS were identified by univariate analysis.
With a median follow-up of 59 months (range, 1-257), the 5-year OS, DSS, and RFS for all patients were 76 %, 83 %, and 79 %, respectively. DSS was significantly poorer for high-grade MEC compared with low/intermediate-grade MEC (5-year DSS 37 % vs 100 %, P < .001). There were 9 disease-specific deaths. The cause of death in 7 patients was distant metastatic disease with locoregional recurrence accounting for death in only 2 patients.
Outcome in patients with mucoepidermoid cancers of the major salivary glands is generally good. Mortality occurs almost exclusively in patients with high-grade tumors. The cause of death in the majority of patients is distant metastatic disease rather than locoregional recurrence.
本研究旨在确定主要涎腺黏液表皮样癌(MEC)患者疾病特异性死亡的发生率和原因。
从 451 例大涎腺癌患者的预先存在的数据库中,确定了 1985 年至 2009 年期间在 Memorial Sloan-Kettering 癌症中心接受治疗的 94 例 MEC 患者。通过回顾性分析患者病历,记录患者、肿瘤和治疗特征。男性 49 例(52%),中位年龄 57 岁(范围,9-89 岁)。94 例患者中,低级别占 49%,中级别占 22%,高级别占 28%。使用 Kaplan-Meier 法计算总生存率(OS)、疾病特异性生存率(DSS)和无复发生存率(RFS)。通过病历审查确定死亡原因。通过单因素分析确定 DSS 的预测因素。
中位随访 59 个月(范围,1-257),所有患者的 5 年 OS、DSS 和 RFS 分别为 76%、83%和 79%。高级别 MEC 的 DSS 明显差于低/中级别 MEC(5 年 DSS 分别为 37%和 100%,P<0.001)。有 9 例疾病特异性死亡。7 例患者的死亡原因为远处转移,仅有 2 例患者的死亡原因为局部区域复发。
大涎腺黏液表皮样癌患者的预后总体良好。死亡率几乎仅发生在高级别肿瘤患者中。大多数患者的死亡原因是远处转移而不是局部区域复发。