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主要涎腺黏液表皮样癌患者的病因特异性死亡率。

Cause-specific mortality in patients with mucoepidermoid carcinoma of the major salivary glands.

机构信息

Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Ann Surg Oncol. 2013 Jul;20(7):2396-404. doi: 10.1245/s10434-013-2872-2. Epub 2013 Feb 9.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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