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儿童大唾液腺恶性肿瘤的临床特征与转归

Clinical characteristics and outcomes of major salivary gland malignancies in children.

作者信息

Radomski Shannon, Dermody Sarah, Harley Earl H

机构信息

Georgetown University School of Medicine, Washington, DC, U.S.A.

Department of Otolaryngology-Head and Neck Surgery, Georgetown University Hospital, Washington, DC, U.S.A.

出版信息

Laryngoscope. 2018 May;128(5):1126-1132. doi: 10.1002/lary.26946. Epub 2017 Oct 9.

Abstract

OBJECTIVES/HYPOTHESIS: Determine demographics, clinical characteristics, and survival rates for children with primary salivary gland malignancies.

STUDY DESIGN

Retrospective, population-based cohort study.

METHODS

All cases of primary salivary gland malignancies diagnosed between the years of 2002 and 2013 in patients ages 0 to 19 years were extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Additional variables collected included age, gender, ethnicity, tumor histological subtype, tumor size, treatment modality, vitality status, and follow-up time. Kaplan-Meier survival curves were generated.

RESULTS

Two hundred forty-five primary salivary gland malignancies were identified (220 parotid, 25 submandibular). Median age at diagnosis was 15 years. Most patients were female (59%), white (74%), and non-Spanish/Hispanic/Latino (81%). Among parotid tumors, mean tumor size was 2.3 cm, and there were 109 (50%) mucoepidermoid carcinomas and 86 (39%) acinic cell carcinomas. Most patients underwent surgery (n = 212, 96%) and 64 (29%) received adjuvant radiation. At a mean follow-up of 62.4 months, 10 patients (5%) were deceased. Kaplan-Meier survival curves illustrated that black children exhibited higher mortality rates than white children (15.8% vs. 4.6%, log-rank = 0.0260) as did those who underwent adjuvant radiation (15.73% vs. 3.2%, log-rank = 0.0209). Among submandibular tumors, mean tumor size was 3.1 cm, and there were 11 (44%) mucoepidermoid carcinomas. All patients underwent surgery and most received adjuvant radiation (n = 15, 60%). At a mean follow-up of 51.25 months, one patient was deceased.

CONCLUSIONS

Salivary gland malignancies in children and adolescents are rare. Overall survival for both parotid and submandibular tumors in children is good.

LEVEL OF EVIDENCE

  1. Laryngoscope, 128:1126-1132, 2018.
摘要

目的/假设:确定原发性涎腺恶性肿瘤患儿的人口统计学特征、临床特征及生存率。

研究设计

基于人群的回顾性队列研究。

方法

从美国国立癌症研究所的监测、流行病学和最终结果数据库中提取2002年至2013年间诊断的所有0至19岁原发性涎腺恶性肿瘤病例。收集的其他变量包括年龄、性别、种族、肿瘤组织学亚型、肿瘤大小、治疗方式、生存状态和随访时间。生成Kaplan-Meier生存曲线。

结果

共识别出245例原发性涎腺恶性肿瘤(220例腮腺肿瘤,25例下颌下腺肿瘤)。诊断时的中位年龄为15岁。大多数患者为女性(59%)、白人(74%)、非西班牙/西班牙裔/拉丁裔(81%)。在腮腺肿瘤中,平均肿瘤大小为2.3 cm,黏液表皮样癌109例(50%),腺泡细胞癌86例(39%)。大多数患者接受了手术(n = 212,96%),64例(29%)接受了辅助放疗。平均随访62.4个月时,10例患者(5%)死亡。Kaplan-Meier生存曲线表明,黑人儿童的死亡率高于白人儿童(15.8%对4.6%,对数秩检验 = 0.0260),接受辅助放疗的儿童也是如此(15.73%对3.2%,对数秩检验 = 0.0209)。在下颌下腺肿瘤中,平均肿瘤大小为3.1 cm,黏液表皮样癌11例(44%)。所有患者均接受了手术,大多数接受了辅助放疗(n = 15,60%)。平均随访51.25个月时,1例患者死亡。

结论

儿童和青少年涎腺恶性肿瘤罕见。儿童腮腺和下颌下腺肿瘤的总体生存率良好。

证据级别

4。《喉镜》,2018年,第128卷,第1126 - 1132页。

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