Rayess Hani M, Dezube Aaron, Bawab Ibrahim, Raza S Naweed, Yoo George H, Lin Ho-Sheng, Jacobs John R
1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
2 Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2017 Sep;157(3):454-461. doi: 10.1177/0194599817700593. Epub 2017 Apr 11.
Objective The effect of tumor differentiation on prognosis of major salivary gland malignancies is controversial. The aim of this study was to determine the effect of tumor differentiation on prognosis by stage in patients with major salivary gland malignancies and to analyze which patient factors are associated with tumor differentiation. Study Design and Setting Cross-sectional analysis of Surveillance, Epidemiology, and End Results (SEER) database. Subjects and Methods In total, 9810 patients who had a major salivary gland malignancy from 2004 to 2012 were identified using the SEER database. Patients with no staging information or no information on histologic differentiation were excluded. A total of 5366 patients were included in the study. For analysis, patients were categorized by American Joint Committee on Cancer (AJCC) stage and subdivided by tumor differentiation. Multivariate analysis was used to analyze the impact of tumor differentiation on survival, tumor location (parotid, submandibular, sublingual), and sex within each AJCC stage of disease. Results Data analysis demonstrated a significant difference in histologic differentiation by stage, with P < .0001. Within stages II, III, and IV, tumor differentiation was significantly associated with a decrease in survival. There was no significant difference in tumor differentiation between the parotid and submandibular gland. Conclusion For patients with stage II, III, and IV disease, tumor differentiation was an independent predictor of survival. This information can be useful when discussing prognosis and can potentially influence management of disease.
目的 肿瘤分化对大唾液腺恶性肿瘤预后的影响存在争议。本研究的目的是确定肿瘤分化对大唾液腺恶性肿瘤患者按分期的预后影响，并分析哪些患者因素与肿瘤分化相关。研究设计与设置 对监测、流行病学和最终结果（SEER）数据库进行横断面分析。对象与方法 利用SEER数据库共识别出2004年至2012年患有大唾液腺恶性肿瘤的9810例患者。排除无分期信息或无组织学分化信息的患者。本研究共纳入5366例患者。为进行分析，患者按美国癌症联合委员会（AJCC）分期进行分类，并按肿瘤分化进行细分。采用多变量分析来分析肿瘤分化对疾病各AJCC分期内生存、肿瘤位置（腮腺、下颌下腺、舌下腺）和性别的影响。结果 数据分析显示按分期的组织学分化存在显著差异，P <.0001。在II期、III期和IV期内，肿瘤分化与生存率降低显著相关。腮腺和下颌下腺之间的肿瘤分化无显著差异。结论 对于II期、III期和IV期疾病的患者，肿瘤分化是生存的独立预测因素。在讨论预后时，该信息可能有用，并可能影响疾病的管理。
