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下颌下腺癌:特殊特征及治疗考量

Submandibular gland cancer: Specific features and treatment considerations.

作者信息

Aro Katri, Tarkkanen Jussi, Saat Riste, Saarilahti Kauko, Mäkitie Antti, Atula Timo

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

School of Dentistry, University of California, Los Angeles, Los Angeles, California.

出版信息

Head Neck. 2018 Jan;40(1):154-162. doi: 10.1002/hed.24981. Epub 2017 Oct 30.

Abstract

BACKGROUND

In the absence of unified treatment protocol, we evaluated the management and outcomes of submandibular gland cancers in an unselected patient series.

METHODS

We included all patients with resected submandibular gland cancer treated at the Helsinki University Hospital from 2000 to 2010 with a 5-year minimum follow-up.

RESULTS

Twenty-five patients with cancer represented 30% of submandibular gland neoplasms, and most were adenoid cystic carcinomas (ACCs; 56%). At presentation, 3 patients showed clinical signs of probable malignancy. Of 22 neck dissection specimens, 5 patients (20%) had metastases with an occult metastasis rate of 4%. Cancer recurred in 11 patients (44%), of which 7 (28%) were only at a distant site. The 5-year disease-specific survival (DSS) and overall survival (OS) rates were 76%, and disease-free survival (DFS) was 68%.

CONCLUSION

Most tumors were ACCs differing from the histological pattern of parotid gland cancers. Occult metastases were rare. The rarity of submandibular gland cancer, its variable histological pattern, and varying biological behavior warrant centralized management.

摘要

背景

在缺乏统一治疗方案的情况下,我们评估了一组未经挑选的患者中下颌下腺癌的治疗情况及预后。

方法

我们纳入了2000年至2010年在赫尔辛基大学医院接受手术切除的所有下颌下腺癌患者,且至少随访5年。

结果

25例癌症患者占下颌下腺肿瘤的30%,大多数为腺样囊性癌(ACC;56%)。初诊时,3例患者有可能为恶性肿瘤的临床体征。在22份颈部清扫标本中,5例患者(20%)有转移,隐匿转移率为4%。11例患者(44%)出现癌症复发,其中7例(28%)仅为远处复发。5年疾病特异性生存率(DSS)和总生存率(OS)为76%,无病生存率(DFS)为68%。

结论

大多数肿瘤为腺样囊性癌,与腮腺癌的组织学模式不同。隐匿转移罕见。下颌下腺癌的罕见性、其多样的组织学模式以及不同的生物学行为需要进行集中管理。

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