Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Head Neck. 2018 Dec;40(12):2596-2605. doi: 10.1002/hed.25335. Epub 2018 Nov 17.
Optimal treatment and prognostic factors affecting long-term survival in patients with sinonasal adenoid cystic carcinoma (ACC) have yet to be clearly defined.
We conducted a retrospective review of patients treated with curative intent from 1980-2015 at MD Anderson Cancer Center.
One hundred sixty patients met inclusion criteria, including 8 who were treated with radiotherapy alone. Median follow-up time was 55 months. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 67.0% and 49.0%, respectively. The 10-year OS and DFS rates were 44.8% and 25.4%, respectively. Factors that portended for poor survival on multivariate analysis were recurrent disease, any solid type histology, epicenter in the sinus cavity, the presence of facial symptoms, or the original disease not treated with surgery. There was no association between surgical margin status or nodal status and survival.
In this large cohort of patients with sinonasal ACC with extended follow-up, long-term survival is better than reported in prior literature. Future research should target patients with adverse risk factors.
目前仍未明确影响鼻腔鼻窦腺样囊性癌（ACC）患者长期生存的最佳治疗方案和预后因素。
我们对 1980 年至 2015 年期间在 MD 安德森癌症中心接受根治性治疗的患者进行了回顾性研究。
共有 160 名患者符合纳入标准，其中 8 名患者仅接受了放疗。中位随访时间为 55 个月。5 年总生存率（OS）和无病生存率（DFS）分别为 67.0%和 49.0%。10 年 OS 和 DFS 率分别为 44.8%和 25.4%。多因素分析显示，疾病复发、任何实体型组织学、窦腔中心、面部症状存在或未手术治疗的原始疾病是生存不良的预后因素。手术切缘状态或淋巴结状态与生存无相关性。
在本研究中，对一组接受了长期随访的鼻腔鼻窦腺样囊性癌患者进行分析，结果显示长期生存率优于既往文献报道。未来的研究应针对具有不良风险因素的患者。
