Yamada Koichiro, Honda Keigo, Tamaki Hisanobu, Tanaka Shinzo, Shinohara Shogo, Takebayashi Shinji, Tateya Ichiro, Kitamura Morimasa, Mizuta Masanobu, Maetani Toshiki, Kojima Tsuyoshi, Kitani Yoshiharu, Asato Ryo, Ichimaru Kazuyuki, Kumabe Yohei, Ushiro Koji, Omori Koichi
Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Japan.
Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama Japan.
Auris Nasus Larynx. 2018 Oct;45(5):1066-1072. doi: 10.1016/j.anl.2018.01.011. Epub 2018 Feb 7.
Clinical studies demonstrating the prognostic factors in submandibular gland carcinoma are limited because the tumor is relatively rare. The aim of this study was to identify clinical outcomes and prognostic factors in submandibular gland carcinoma.
The study included 65 patients with submandibular gland carcinoma who underwent initial surgical treatment at the Kyoto University and its affiliated hospitals.
The 3-year overall survival (OS), disease specific survival, locoregional control (LRC), and no distant metastasis (NDM) rates were 74.2%, 74.2%, 90.0%, and 64.8%, respectively. In the current follow-up study, 16 patients died of the disease, 5 patients were alive with recurrence, 43 patients were alive without disease, and 1 patient died of unrelated disease without recurrence. All patients who died of the disease had developed distant metastasis. Based on univariate analysis, tumor grade (high grade) and lymph node metastases (≥N2) were significant prognostic factors for OS and LRC. It also revealed tumor grade (high grade), T classification (≥T3), and lymph node metastases (≥N2) were significant for distant metastasis. Multivariate analysis showed the following significant prognostic factors: lymph node metastases (≥N2) for OS, LRC, and NDM, and high tumor grade for NDM.
Our study suggested death of submandibular gland carcinoma occurred mainly due to distant metastasis. The significant predictors of distant metastasis were lymph node metastases (≥N2) and tumor grade (high grade).
由于下颌下腺癌相对罕见，因此关于其预后因素的临床研究有限。本研究旨在确定下颌下腺癌的临床结局和预后因素。
本研究纳入了65例在京都大学及其附属医院接受初次手术治疗的下颌下腺癌患者。
3年总生存率（OS）、疾病特异性生存率、局部区域控制率（LRC）和无远处转移率（NDM）分别为74.2%、74.2%、90.0%和64.8%。在本次随访研究中，16例患者死于该疾病，5例患者复发后仍存活，43例患者无病存活，1例患者未复发死于无关疾病。所有死于该疾病的患者均发生了远处转移。单因素分析显示，肿瘤分级（高级别）和淋巴结转移（≥N2）是OS和LRC的重要预后因素。分析还显示，肿瘤分级（高级别）、T分类（≥T3）和淋巴结转移（≥N2）对远处转移具有重要意义。多因素分析显示以下重要预后因素：OS、LRC和NDM的淋巴结转移（≥N2），以及NDM的高肿瘤分级。
我们的研究表明，下颌下腺癌死亡主要是由于远处转移。远处转移的重要预测因素是淋巴结转移（≥N2）和肿瘤分级（高级别）。
