腮腺多形性腺瘤癌变患者的临床结局：来自单一三级中心的比较研究
Clinical outcome of patients with carcinoma ex pleomorphic adenoma of the parotid gland: a comparative study from a single tertiary center.
作者信息
Lim Chwee Ming, Hobson Candace, Kim Seungwon, Johnson Jonas T
机构信息
Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania; Department of Otolaryngology Head and Neck Surgery, National University Health System, Singapore.
出版信息
Head Neck. 2015 Apr;37(4):543-7. doi: 10.1002/hed.23638. Epub 2014 Apr 10.
BACKGROUND
Carcinoma ex pleomorphic adenoma (CXPA) of the parotid gland is a high-grade cancer and the prognosis of this cancer has not been compared with non-CXPA high-grade primary parotid cancer.
METHODS
Retrospective medical chart review of patients with surgically treated high-grade primary parotid cancer (21 CXPA and 52 non-CXPA) was performed with correlation with disease-specific survival, locoregional recurrence, and distant recurrence.
RESULTS
Despite having similar stage of cancer and extent of surgical resection, patients with CXPA had a lower disease-specific survival compared to non-CXPA high-grade primary parotid cancer (p = .02). Salivary duct cancer (SDC) was the commonest histologic variant in both cohorts and around 40% of patients with SDC died of distant recurrence that occurred within 3 years from diagnosis.
CONCLUSION
CXPA of the parotid gland is a more aggressive cancer compared to non-CXPA high-grade primary parotid cancer. SDC was associated with a high chance of delayed distant recurrence, which contributed directly to the mortality of this cancer.
背景
腮腺多形性腺瘤癌变（CXPA）是一种高级别癌症，且该癌症的预后尚未与非CXPA高级别原发性腮腺癌进行比较。
方法
对接受手术治疗的高级别原发性腮腺癌患者（21例CXPA和52例非CXPA）进行回顾性病历审查，并与疾病特异性生存率、局部区域复发和远处复发相关联。
结果
尽管CXPA患者和非CXPA高级别原发性腮腺癌患者的癌症分期和手术切除范围相似，但CXPA患者的疾病特异性生存率低于非CXPA高级别原发性腮腺癌患者（p = 0.02）。涎腺导管癌（SDC）是两个队列中最常见的组织学变体，约40%的SDC患者死于诊断后3年内发生的远处复发。
结论
与非CXPA高级别原发性腮腺癌相比，腮腺CXPA是一种侵袭性更强的癌症。SDC与远处复发延迟的高几率相关，这直接导致了该癌症的死亡率。
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