Allan Bassan J, Tashiro Jun, Diaz Sofia, Edens Jason, Younis Ramzi, Thaller Seth R
From the * Division of General Surgery, DeWitt-Daughtry Family Department of Surgery; †Division of Plastic and Reconstructive Surgery, Leonard Miller School of Medicine, University of Miami; and ‡Division of Pediatric Otorhinolaryngology, Leonard Miller School of Medicine, University of Miami, Miami, FL.
J Craniofac Surg. 2013 Sep;24(5):1660-4. doi: 10.1097/SCS.0b013e3182997d52.
Population-based analysis of the incidence, demographics, and management outcomes in children with malignant tumors of the parotid gland.
Surveillance, Epidemiology, and End Results database (1973-2009) was researched for all patients younger than 20 years.
Overall, 284 patients were identified. Annual incidence of these tumors was 1.43 cases per million. The highest incidence occurred in girls (0.86/1,000,000), black children (0.849/1,000,000), and adolescents (1.56/1,000,000). Median age at diagnosis was 13.5 years. Most patients were 10 years or older (n = 256, 90%). Most patients presented with local disease (n = 207, 76%). Only 3% had metastasis at time of diagnosis. Most tumors were mucoepidermoid carcinomas (n = 139, 49%) or acinar cell carcinomas (n = 113, 40%). There were no differences in survival between mucoepidermoid and acinar cell carcinomas (96% vs 98% respectively, P = 0.317). Overall mortality was 4.6% over the study period. Overall survival was 96% at 5 years, 95% at 10 years, and 83% at 20 years. Adolescents had significantly higher mortality rates (7.1% vs 1.6% for children <15 years of age, P = 0.23). Multivariate analysis identified the use of adjuvant radiation therapy (hazard ratio, 6.01; 95% confidence interval, 1.15-31.45; P = 0.034) as the only independent predictor of poor outcome.
Malignant parotid gland tumors are most common in adolescents, and this subgroup has worse outcomes. The role of radiotherapy remains controversial.
基于人群对腮腺恶性肿瘤患儿的发病率、人口统计学特征及治疗结局进行分析。
对监测、流行病学和最终结果数据库（1973 - 2009年）中所有20岁以下的患者进行研究。
总体上，共识别出284例患者。这些肿瘤的年发病率为每百万人口1.43例。发病率最高的是女孩（0.86/1,000,000）、黑人儿童（0.849/1,000,000）和青少年（1.56/1,000,000）。诊断时的中位年龄为13.5岁。大多数患者年龄在10岁及以上（n = 256，90%）。大多数患者表现为局部疾病（n = 207，76%）。仅3%的患者在诊断时出现转移。大多数肿瘤为黏液表皮样癌（n = 139，49%）或腺泡细胞癌（n = 113，40%）。黏液表皮样癌和腺泡细胞癌的生存率无差异（分别为96%和98%，P = 0.317）。在研究期间总体死亡率为4.6%。5年总生存率为96%，10年为95%，20年为83%。青少年的死亡率显著更高（15岁以下儿童为1.6%，青少年为7.1%，P = 0.23）。多变量分析确定辅助放疗的使用（风险比，6.01；95%置信区间，1.15 - 31.45；P = 0.034）是不良结局的唯一独立预测因素。
腮腺恶性肿瘤在青少年中最为常见，且该亚组的结局较差。放疗的作用仍存在争议。
