下颌下腺恶性肿瘤的长期结局与预后：一项多中心研究。

Long-term outcomes and prognosis in submandibular gland malignant tumors: A multicenter study.

作者信息

Lombardi Davide, Accorona Remo, Lambert Arnaud, Mercante Giuseppe, Coropciuc Ruxandra, Paderno Alberto, Lancini Davide, Spriano Giuseppe, Nicolai Piero, Vander Poorten Vincent

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Italy.

Department of Otorhinolaryngology-Head and Neck Surgery, Catholic University Leuven, Leuven, Belgium.

出版信息

Laryngoscope. 2018 Dec;128(12):2745-2750. doi: 10.1002/lary.27236. Epub 2018 May 14.

DOI:10.1002/lary.27236

PMID:29756241

Abstract

OBJECTIVES/HYPOTHESIS: Submandibular gland tumors (SMGTs) are rare and characterized by heterogeneity in histologic profiles. The aim of the present study was to retrieve data on submandibular gland (SMG) malignancies and identify factors influencing survival.

STUDY DESIGN

Retrospective study.

METHODS

A multicenter, retrospective study on patients who underwent primary surgery for SMGTs at three referral centers was performed.

RESULTS

Among 204 patients with SMGTs, 50 (24.5%) with SMG malignancies were analyzed in detail. Definitive pT status was: 21 (42%) pT1, 14 (28%) pT2, 10 (20%) pT3, and five (10%) pT4. Nodal metastases and perineural spread were diagnosed in 15 (30%) and 25 (50%) patients, respectively. High-grade lesions were identified in 32 (64%) patients. Follow-up status, available for 49 (98%) patients, was as follows: 23 (47%) patients were alive without disease, 11 (22.5%) died of disease, five (10.2%) alive with disease, and 10 (20.4%) died of other causes. Five- and 10-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were 66.4% and 57.1%, 76.6% and 72.1%, 69.1% and 62.4%, respectively. At univariate analysis, OS, DSS, and RFS were influenced by pT status, pN status, and perineural spread. OS and RFS were also affected by the presence of facial palsy and pain. RFS was negatively influenced by positive margins. Multivariate analysis confirmed that OS, DSS, and RFS were independently affected by perineural spread, whereas nodal involvement influenced only RFS.

CONCLUSIONS

The malignancy rate of SMGTs is comparable to that reported for parotid tumors. Most patients presented with high-grade lesions. pT status, pN status, and perineural spread significantly affected prognosis.

LEVEL OF EVIDENCE

4 Laryngoscope, 128:2745-2750, 2018.

摘要

目的/假设：下颌下腺肿瘤（SMGTs）较为罕见，组织学特征具有异质性。本研究的目的是收集下颌下腺（SMG）恶性肿瘤的数据，并确定影响生存的因素。

研究设计

回顾性研究。

方法

对在三个转诊中心接受SMGTs初次手术的患者进行多中心回顾性研究。

结果

在204例SMGTs患者中，对50例（24.5%）SMG恶性肿瘤患者进行了详细分析。确切的pT分期为：21例（42%）为pT1，14例（28%）为pT2，10例（20%）为pT3，5例（10%）为pT4。分别有15例（30%）和25例（50%）患者诊断为淋巴结转移和神经周围扩散。32例（64%）患者为高级别病变。49例（98%）患者的随访情况如下：23例（47%）患者无病存活，11例（22.5%）患者死于疾病，5例（10.2%）患者带瘤存活，10例（20.4%）患者死于其他原因。5年和10年总生存率（OS）、疾病特异性生存率（DSS）和无复发生存率（RFS）分别为66.4%和57.1%、76.6%和72.1%、69.1%和62.4%。单因素分析显示，OS、DSS和RFS受pT分期、pN分期和神经周围扩散的影响。OS和RFS也受面神经麻痹和疼痛的影响。切缘阳性对RFS有负面影响。多因素分析证实，OS、DSS和RFS独立受神经周围扩散影响，而淋巴结受累仅影响RFS。