腺样囊性癌患者颈部淋巴结转移的发生率及其与预后的关系。一项国际合作研究。
Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma. An international collaborative study.
作者信息
Amit Moran, Binenbaum Yoav, Sharma Kanika, Ramer Naomi, Ramer Ilana, Agbetoba Abib, Glick Joelle, Yang Xinjie, Lei Delin, Bjørndal Kristine, Godballe Christian, Mücke Thomas, Wolff Klaus-Dietrich, Fliss Dan, Eckardt André M, Copelli Chiara, Sesenna Enrico, Palmer Frank, Ganly Ian, Patel Snehal, Gil Ziv
机构信息
Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.
The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam Rambam Medical Center, the Technion, Israel Institute of Technology, Israel.
出版信息
Head Neck. 2015 Jul;37(7):1032-7. doi: 10.1002/hed.23711. Epub 2014 Jul 24.
BACKGROUND
The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established.
METHODS
We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection.
RESULTS
The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival.
CONCLUSION
Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity.
背景
头颈部腺样囊性癌（ACC）的区域转移模式及其与预后的关系尚未明确。
方法
我们对270例行颈部清扫术的患者进行了一项回顾性多中心多变量分析。
结果
颈部转移的发生率为29%。口腔部位观察到的发生率为37%，大唾液腺部位为19%（p = .001）。隐匿性淋巴结转移率为17%。接受治疗性颈部清扫术的患者总体5年生存率为44%，接受择期颈部清扫术且有和无淋巴结转移的患者分别为65%和73%（p = .017）。多变量分析显示，原发部位、淋巴结分类和切缘状态是生存的独立预测因素。
结论
我们的研究结果支持对口腔ACC患者考虑进行择期颈部治疗。
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