Lee So-Yoon, Kim Bo Hwan, Choi Eun Chang
Department of Otorhinolaryngology Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Head Neck. 2014 Dec;36(12):1796-801. doi: 10.1002/hed.23537. Epub 2014 Apr 3.
The purposes of this study were to evaluate the oncologic outcomes of salivary gland adenoid cystic carcinoma (ACC) and to confirm the benefits of elective neck dissection.
We reviewed the records of 61 consecutive patients with ACC. Surgery was performed in all patients.
The occult metastasis rate was 15.38% (4 of 26 patients) and no regional recurrence in the elective neck dissection group was identified. Among 4 clinically node positive (cN+) patients, regional metastasis was identified in 3 through therapeutic neck dissection. Regional recurrence was identified in 4 patients (4 of 31) who had never undergone elective neck treatment of clinically node negative (cN-) status, exclusively. Overall regional metastases (overall N+) were identified in 11 patients. The overall survival rate was 84.99% at 5 years, 81.13% at 10 and 15 years in (overall N-) status, contrary to 56.82% at 5 years and 28.41% at 10 years in overall N+ status (p = .025).
Careful follow-up of regional status is important, and proper therapeutic and elective neck treatment can achieve regional control in ACC. Elective neck dissection is recommendable and can provide valuable staging and prognostic information.
本研究旨在评估涎腺腺样囊性癌（ACC）的肿瘤学结局，并确认选择性颈清扫术的益处。
我们回顾了61例连续性ACC患者的记录。所有患者均接受了手术治疗。
隐匿性转移率为15.38%（26例患者中的4例），选择性颈清扫术组未发现区域复发。在4例临床淋巴结阳性（cN+）患者中，通过治疗性颈清扫术发现3例有区域转移。在仅对临床淋巴结阴性（cN-）状态未进行选择性颈部治疗的31例患者中，有4例出现区域复发。总共11例患者被确定有区域转移（总体N+）。总体N-状态患者5年总生存率为84.99%，10年和15年分别为81.13%，而总体N+状态患者5年总生存率为56.82%，10年为28.41%（p = 0.025）。
仔细随访区域状态很重要，适当的治疗性和选择性颈部治疗可实现ACC的区域控制。推荐进行选择性颈清扫术，其可为分期和预后提供有价值的信息。
