Spiro R H, Armstrong J, Harrison L, Geller N L, Lin S Y, Strong E W
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.
Arch Otolaryngol Head Neck Surg. 1989 Mar;115(3):316-21. doi: 10.1001/archotol.1989.01860270058015.
We have reviewed a 44-year experience with previously untreated carcinomas arising in major salivary glands to compare 319 patients treated before 1966 with 155 who received therapy between 1966 and 1982. Actuarial analysis indicates that five- and ten-year survival of our more recently treated patients was 80% and 65%, compared with 60% and 50% in patients treated before 1966. Explanation for this includes the higher proportion of patients with less aggressive histologic subtypes seen in recent years, as well as the fact that many of our patients treated before 1966 had surgical procedures considered inadequate by current standards. We also believe that adjunctive radiation oncology enhanced survival, but it could not be proved in this retrospective study. Multivariate analysis confirms that the clinical stage was the most important prognostic variable.
我们回顾了44年以来对原发性大唾液腺癌患者未经治疗的情况,将1966年以前接受治疗的319例患者与1966年至1982年间接受治疗的155例患者进行比较。精算分析表明,我们最近治疗的患者5年和10年生存率分别为80%和65%,而1966年以前治疗的患者分别为60%和50%。对此的解释包括近年来侵袭性较小的组织学亚型患者比例较高,以及1966年以前接受治疗的许多患者的手术程序按当前标准被认为不够充分。我们还认为辅助放射肿瘤学提高了生存率,但在这项回顾性研究中无法得到证实。多变量分析证实临床分期是最重要的预后变量。