Chakrabarti Swagnik, Nair Deepa, Malik Akshat, Qayyumi Burhanuddin, Nair Sudhir, Agrawal Jai Prakash, Chaturvedi Pankaj
Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Radiotherapy, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Indian J Cancer. 2018 Jan-Mar;55(1):98-104. doi: 10.4103/ijc.IJC_503_17.
Parotid cancers are uncommon and have a relatively long natural history. Determination of prognostic factors affecting the outcome is difficult.
The primary objective was to determine the demographic, clinical, histopathology and treatment-related factors affecting overall survival (OS) in parotid cancers. The secondary objective was to study the impact of these factors on disease-free survival (DFS) and patterns of failure. Data of consecutive patients who underwent parotidectomy for primary parotid malignancy between July 2006 and April 2015 with at least 6 months of posttreatment follow-up were retrospectively retrieved. Patients whose follow-up status was known at the time of analysis were included. One hundred and sixty-five patients met the inclusion criteria.
The median follow-up was 38 months. The mean OS and DFS were 141.03 and 124.38 months, respectively. Age > 45 years affected both OS and DFS (P = 0.00 and 0.002 respectively) adversely. Advanced T stage affected adversely OS in univariate (P = 0.00) but not in multivariate analysis (P = 0.91) and DFS in both univariate (P = 0.00) and multivariate analysis (P = 0.005). Nodal positivity adversely affected survival adversely in univariate (P = 0.00 for OS and DFS) and multivariate analysis (P = 0.022 for OS and P = 0.001 for DFS). Resection margin of < 5mm affected OS as compared to a margin of ≥5mm (P = 0.03).
Nodal positivity is the single most important factor affecting survival in parotid cancers. A histopathological resection margin of at least 5 mm is desirable. Advanced age along with high grade, advanced T and N stages need to be considered for adjuvant treatment.
腮腺癌并不常见，其自然病程相对较长。确定影响预后的因素很困难。
主要目的是确定影响腮腺癌总生存期（OS）的人口统计学、临床、组织病理学和治疗相关因素。次要目的是研究这些因素对无病生存期（DFS）和复发模式的影响。回顾性检索了2006年7月至2015年4月期间因原发性腮腺恶性肿瘤接受腮腺切除术且术后随访至少6个月的连续患者的数据。纳入分析时随访状态已知的患者。165例患者符合纳入标准。
中位随访时间为38个月。平均总生存期和无病生存期分别为141.03个月和124.38个月。年龄>45岁对总生存期和无病生存期均有不利影响（分别为P = 0.00和0.002）。在单因素分析中，晚期T分期对总生存期有不利影响（P = 0.00），但在多因素分析中无影响（P = 0.91），在单因素（P = 0.00）和多因素分析（P = 0.005）中对无病生存期均有不利影响。淋巴结阳性在单因素分析（总生存期和无病生存期的P均为0.00）和多因素分析（总生存期的P = 0.022，无病生存期的P = 0.001）中均对生存有不利影响。与切缘≥5mm相比，切缘<5mm影响总生存期（P = 0.03）。
淋巴结阳性是影响腮腺癌生存的最重要单一因素。组织病理学切缘至少5mm是理想的。高龄以及高级别、晚期T和N分期需要考虑进行辅助治疗。
