Safdieh Joseph, Givi Babak, Osborn Virginia, Lederman Ariel, Schwartz David, Schreiber David
1 Department of Veteran Affairs, NY Harbor Campus, Brooklyn, New York, USA.
2 SUNY Downstate Medical Center, Brooklyn, New York, USA.
Otolaryngol Head Neck Surg. 2017 Dec;157(6):988-994. doi: 10.1177/0194599817717661. Epub 2017 Jul 4.
Objective Using the National Cancer Database (NCDB), we investigated the characteristics, outcomes, and benefits of adjuvant therapy for patients diagnosed with malignant salivary gland tumors between 2004 and 2012. Study Design Retrospective analysis. Setting NCDB. Subject and Methods The cases of patients diagnosed with a nonmetastatic major salivary gland tumor who underwent resection between 2004 and 2012 were abstracted from the NCDB. Patients were further included if they had pT1-4NX-1M0 high-grade disease or pT3-4NX-0M0 or pT1-4N1M0 low-grade disease. Patients were identified as having no postoperative radiation therapy or having received postoperative radiation therapy to a dose of 5000 and 7000 cGy to the head and neck region or the parotid region, and their characteristics and outcomes were compared. Results During the study period, 4068 patients met the inclusion criteria for this analysis, of which 2728 (67.1%) received postoperative radiation and 1340 (32.9%) did not. With a median follow-up of 49.1 months, there was a significant improvement in overall survival associated with those receiving postoperative radiation (5 years, 56% vs 50.6%). On multivariable analysis, radiation utilization (hazard ratio, 0.78; 95% CI, 0.71-0.86; P < 0.001) and female sex (hazard ratio, 0.88) were associated with improved survival. When the analysis was limited to patients ≤65 years old, the survival benefit was persistent on multivariable analysis. Conclusion In conclusion, in this large NCDB study of 4068 patients with locally advanced malignant salivary gland carcinoma, administering adjuvant radiotherapy was associated with improved overall survival.
目的 利用国家癌症数据库（NCDB），我们调查了2004年至2012年间诊断为恶性涎腺肿瘤患者辅助治疗的特征、结局及益处。研究设计 回顾性分析。研究地点 NCDB。研究对象与方法 从NCDB中提取2004年至2012年间诊断为非转移性大涎腺肿瘤并接受手术切除的患者病例。如果患者患有pT1 - 4NX - 1M0高级别疾病或pT3 - 4NX - 0M0或pT1 - 4N1M0低级别疾病，则进一步纳入研究。将患者分为未接受术后放疗组或接受头颈部或腮腺区域5000至7000 cGy剂量术后放疗组，并比较其特征和结局。结果 在研究期间，4068例患者符合本分析的纳入标准，其中2728例（67.1%）接受了术后放疗，1340例（32.9%）未接受。中位随访时间为49.1个月时，接受术后放疗的患者总生存率有显著提高（5年生存率，56%对50.6%）。多变量分析显示，放疗使用情况（风险比，0.78；95%可信区间为0.71 - 0.86；P < 0.001）和女性性别（风险比, 0.88）与生存率提高相关。当分析限于年龄≤65岁患者时，多变量分析显示生存获益持续存在。结论 总之，在这项对4068例局部晚期恶性涎腺癌患者的大型NCDB研究中,给予辅助放疗与总生存率提高相关。
