Bjørndal Kristine, Krogdahl Annelise, Therkildsen Marianne H, Charabi Birgitte, Kristensen Claus A, Andersen Elo, Schytte Sten, Primdahl Hanne, Johansen Jørgen, Pedersen Henrik B, Andersen Lisbeth J, Godballe Christian
Department of ORL-HNS, Odense University Hospital, Denmark.
Department of Pathology, Odense University Hospital, Denmark.
Oral Oncol. 2015 Dec;51(12):1138-42. doi: 10.1016/j.oraloncology.2015.10.002. Epub 2015 Oct 21.
To describe outcome and prognostic factors, including the effect of radiotherapy, in a consecutive national series of salivary gland adenoid cystic carcinomas.
From the national Danish salivary gland carcinoma database in the structure of DAHANCA, 201 patients diagnosed with adenoid cystic carcinoma, and treated with a curative intent, were identified in the period between 1990 and 2005. Variables necessary for statistical analyses were extracted from the database.
The 10-year crude survival and disease specific survival rates were 58% and 75%, respectively. The 10-year locoregional control rate was 70%, and 36% of patients experienced a recurrence during follow-up (median 7.5 years); 18% developed distant metastases (most commonly to the lungs). In multivariate analysis, stage and margin status were both important factors with regards to survival and locoregional control. Radiotherapy did not improve survival, but it did improve the locoregional control rate.
The treatment of choice is surgery with as wide margins as possible including elective, selective neck dissection. Adjuvant radiotherapy should be considered in patients with incomplete tumor resection, high disease stages, and tumors with a solid growth pattern.
在丹麦全国一系列连续性涎腺腺样囊性癌病例中描述治疗结果及预后因素,包括放疗的作用。
从丹麦癌症协会(DAHANCA)结构中的全国涎腺癌数据库中,识别出1990年至2005年间确诊为腺样囊性癌并接受根治性治疗的201例患者。从数据库中提取统计分析所需的变量。
10年总生存率和疾病特异性生存率分别为58%和75%。10年局部区域控制率为70%,36%的患者在随访期间(中位随访7.5年)出现复发;18%发生远处转移(最常见于肺部)。多因素分析显示,分期和切缘状态是影响生存和局部区域控制的重要因素。放疗虽未提高生存率,但提高了局部区域控制率。
首选治疗方法是手术,尽可能切缘广泛,包括选择性颈清扫术。对于肿瘤切除不完全、疾病分期高以及呈实性生长模式的肿瘤患者,应考虑辅助放疗。