Jayaprakash Vijayvel, Merzianu Mihai, Warren Graham W, Arshad Hassan, Hicks Wesley L, Rigual Nestor R, Sullivan Maureen A, Seshadri Mukund, Marshall James R, Cohan David M, Zhao Yujie, Singh Anurag K
Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, New York; Department of Dentistry and Maxillofacial Prosthetics, Roswell Park Cancer Institute, Buffalo, New York.
Head Neck. 2014 May;36(5):694-701. doi: 10.1002/hed.23350. Epub 2013 Oct 7.
The survival rates and prognostic factors for salivary duct carcinoma (SDC) are not clear.
Survival estimates and prognostic factors were evaluated for 228 patients with SDC identified from the Surveillance, Epidemiology, and End Results (SEER) database.
Median overall survival (OS) duration for patients with SDC was 79 months and 5-year disease-specific survival (DSS) rate was 64%. Among patients with SDC with lymph node involvement, larger primary tumor size (>3 cm) was associated with twice the risk of death (p < .03). Factors predictive of improved DSS were age (p = .01), tumor size (p = .006), tumor grade (p = .02), and lymph node involvement (p < .001). Adjuvant radiotherapy did not improve survival when compared to surgery alone for early-stage (I-II) disease (p = .28).
Younger patients with SDC (<50 years) showed a better prognosis. Primary tumor size and lymph node involvement were independent and additive risk factors for poor prognosis. The role of adjuvant radiotherapy in the treatment of SDC needs to be explored further.
涎腺导管癌(SDC)的生存率及预后因素尚不清楚。
对从监测、流行病学及最终结果(SEER)数据库中识别出的228例SDC患者的生存情况及预后因素进行评估。
SDC患者的中位总生存期(OS)为79个月,5年疾病特异性生存率(DSS)为64%。在有淋巴结受累的SDC患者中,原发肿瘤较大(>3 cm)与死亡风险增加两倍相关(p < 0.03)。预测DSS改善的因素包括年龄(p = 0.01)、肿瘤大小(p = 0.006)、肿瘤分级(p = 0.02)及淋巴结受累情况(p < 0.001)。对于早期(I-II期)疾病,与单纯手术相比,辅助放疗并未改善生存率(p = 0.28)。
年龄小于50岁的SDC患者预后较好。原发肿瘤大小及淋巴结受累是预后不良的独立且累加的危险因素。辅助放疗在SDC治疗中的作用有待进一步探索。