Amit Moran, Na'ara Shorook, Trejo-Leider Leonor, Ramer Naomi, Burstein David, Yue Ma, Miles Brett, Yang Xinjie, Lei Delin, Bjoerndal Kristine, Godballe Christian, Mücke Thomas, Wolff Klaus-Dietrich, Eckardt André M, Copelli Chiara, Sesenna Enrico, Patel Snehal, Ganly Ian, Gil Ziv
The Head and Neck Center, Department of Otolaryngology - Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.
The Clinical Research Institute at Rambam, Rambam Medical Center, Rappaport Faculty of Medicine and Research Institute, The Technion, Israel Institute of Technology, Haifa, Israel.
Head Neck. 2017 May;39(5):1008-1014. doi: 10.1002/hed.24740. Epub 2017 Mar 2.
The mainstay of treatment in adenoid cystic carcinoma (ACC) of the head and neck is surgical resection with negative margins. The purpose of this study was to define the margin status that associates with survival outcomes of ACC of the head and neck.
We conducted univariate and multivariate analyses of international data.
Data of 507 patients with ACC of the head and neck were analyzed; negative margins defined as ≥5 mm were detected in 253 patients (50%). On multivariate analysis, the hazard ratios (HRs) of positive margin status were 2.68 (95% confidence interval [CI], 1.2-6.2; p = .04) and 2.63 (95% CI, 1.1-6.3; p = .03) for overall survival (OS) and disease-specific survival (DSS), respectively. Close margins had no significant impact on outcome, with HRs of 1.1 (95% CI, 0.4-3.0; p = .12) and 1.07 (95% CI, 0.3-3.4; p = .23) for OS and DSS, respectively, relative with negative margins.
In head and neck ACC, positive margins are associated with the worst outcome. Negative or close margins are associated with improved outcome, regardless of the distance from the tumor. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1008-1014, 2017.
头颈部腺样囊性癌（ACC）的主要治疗方法是手术切除且切缘阴性。本研究的目的是确定与头颈部ACC生存结果相关的切缘状态。
我们对国际数据进行了单因素和多因素分析。
分析了507名头颈部ACC患者的数据；253名患者（50%）检测到切缘阴性定义为≥5毫米。多因素分析显示，切缘阳性状态对总生存（OS）和疾病特异性生存（DSS）的风险比（HR）分别为2.68（95%置信区间[CI]，1.2 - 6.2；p = 0.04）和2.63（95%CI，1.1 - 6.3；p = 0.03）。切缘接近对结果无显著影响，与切缘阴性相比，OS和DSS的HR分别为1.1（95%CI，0.4 - 3.0；p = 0.12）和1.07（95%CI，0.3 - 3.4；p = 0.23）。
在头颈部ACC中，切缘阳性与最差的结果相关。切缘阴性或接近与改善的结果相关，无论与肿瘤的距离如何。©2017威利期刊公司。《头颈》39: 1008 - 1014, 2017。
