涎腺导管癌：治疗、预后及失败模式。
Salivary duct carcinoma: Treatment, outcomes, and patterns of failure.
作者信息
Johnston Meredith L, Huang Shao Hui, Waldron John N, Atenafu Eshetu G, Chan Kelvin, Cummings Bernard J, Gilbert Ralph W, Goldstein David, Gullane Patrick J, Irish Jonathan C, Perez-Ordonez Bayardo, Weinreb Ilan, Bayley Andrew, Cho John, Dawson Laura A, Hope Andrew, Ringash Jolie, Witterick Ian J, O'Sullivan Brian, Kim John
机构信息
Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Department of Biostatistics, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
出版信息
Head Neck. 2016 Apr;38 Suppl 1:E820-6. doi: 10.1002/hed.24107. Epub 2015 Jul 15.
BACKGROUND
Salivary duct carcinoma is rare, with distinct morphology and behavior. We reviewed our institutional experience with salivary duct carcinoma, aiming to characterize clinical behavior and treatment outcomes.
METHODS
All salivary duct carcinomas treated curatively between 1999 and 2010 were reviewed. Overall survival (OS), locoregional control, distant control, and patterns of failure were analyzed. Multivariate analysis identified predictors of OS.
RESULTS
Fifty-four patients with salivary duct carcinoma (parotid gland = 49; submandibular gland = 5) were included in the analysis. Fifty-three patients underwent primary surgery, and 48 (89%) received postoperative radiotherapy (RT; median dose = 60 Gy). Median follow-up was 5.7 years. The 5-year OS, locoregional control, and distant control were 43%, 70%, and 48%, respectively. Nine local (6 involving facial nerve), 10 regional, and 28 distant failures were identified. Multiple pathologic involved lymph nodes (pN2b/N2c) predicted reduced OS (hazard ratio [HR] = 3.6; p = .02).
CONCLUSION
Distant recurrence is common. Presence of pN2b/N2c disease is associated with reduced OS. Local recurrence frequently involves the facial nerves. © 2015 Wiley Periodicals, Inc. Head Neck 38: E820-E826, 2016.
背景
涎腺导管癌较为罕见，具有独特的形态和行为。我们回顾了本机构涎腺导管癌的治疗经验，旨在描述其临床行为和治疗结果。
方法
回顾了1999年至2010年间接受根治性治疗的所有涎腺导管癌患者。分析了总生存期（OS）、局部区域控制、远处控制和失败模式。多变量分析确定了OS的预测因素。
结果
分析纳入了54例涎腺导管癌患者（腮腺49例；颌下腺5例）。53例患者接受了初次手术，48例（89%）接受了术后放疗（RT；中位剂量=60 Gy）。中位随访时间为5.7年。5年OS、局部区域控制和远处控制分别为43%、70%和48%。确定了9例局部复发（6例累及面神经）、10例区域复发和28例远处复发。多个病理累及淋巴结（pN2b/N2c）预示OS降低（风险比[HR]=3.6；p=.02）。
结论
远处复发常见。pN2b/N2c疾病的存在与OS降低相关。局部复发常累及面神经。©2015威利期刊公司。《头颈》38:E820-E826，2016年。
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