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头颈部腺样囊性癌:一项回顾性多中心研究。

Adenoid cystic carcinoma of the head and neck: a retrospective multicenter study.

作者信息

Takebayashi Shinji, Shinohara Shogo, Tamaki Hisanobu, Tateya Ichiro, Kitamura Morimasa, Mizuta Masanobu, Tanaka Shinzo, Kojima Tsuyoshi, Asato Ryo, Maetani Toshiki, Ushiro Koji, Kitani Yoshiharu, Ichimaru Kazuyuki, Honda Keigo, Yamada Koichiro, Omori Koichi

机构信息

a Department of Otolaryngology - Head and Neck Surgery , Kobe City Medical Center General Hospital , Kobe , Japan.

b Department of Otolaryngology - Head and Neck Surgery , Kurashiki Central Hospital , Kurashiki , Japan.

出版信息

Acta Otolaryngol. 2018 Jan;138(1):73-79. doi: 10.1080/00016489.2017.1371329. Epub 2017 Sep 12.

Abstract

BACKGROUND

Adenoid cystic carcinoma of the head and neck (ACCHN) is rare and difficult to study effective treatment at one institute. Our aim is to identify prognostic factors for this disease by conducting a multicenter study at 11 institutions in Japan.

METHODS

A retrospective multicenter study of ACCHN was performed. One hundred and three patients were identified between 2006 and 2015. The overall survival (OS) rate for all patients was calculated, and OS, locoregional control (LRC) rate, or no distant metastasis (NDM) rate was calculated for patients in that the surgery was performed without distant metastasis (DM). Statistical analyses were performed.

RESULTS

A significant difference with multivariate analysis was observed in patients in sublingual glands, stage IV and the use of radiation therapy ≥60Gy (sufficient RT) in OS for all patients. A significant difference was observed in the use of sufficient postoperative RT in the OS and the LRC rate, and in pathological surgical margins in the NDM rate.

CONCLUSION

Sublingual glands or stage IV was a poorer, and sufficient RT was a better prognostic factor for ACCHN. Sufficient RT was effective to prevent local recurrence after surgical resection. Positive surgical margins caused an increase in DM.

摘要

背景

头颈部腺样囊性癌(ACCHN)较为罕见,在单一机构难以开展有效的治疗研究。我们的目的是通过在日本11家机构进行多中心研究,确定该疾病的预后因素。

方法

对ACCHN进行回顾性多中心研究。在2006年至2015年间共纳入103例患者。计算所有患者的总生存率(OS),并对无远处转移(DM)而行手术治疗的患者计算OS、局部区域控制率(LRC)或无远处转移率(NDM)。进行统计学分析。

结果

在所有患者的OS方面,舌下腺、IV期以及放疗剂量≥60Gy(充分放疗)在多因素分析中存在显著差异。在OS和LRC率方面,术后充分放疗的使用存在显著差异,在NDM率方面,病理手术切缘存在显著差异。

结论

舌下腺或IV期预后较差,充分放疗是ACCHN较好的预后因素。充分放疗对预防手术切除后的局部复发有效。手术切缘阳性会导致DM增加。

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