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高转移性淋巴结数量,而非结外侵犯,是手术治疗淋巴结转移性涎腺癌患者的淋巴结相关预后因素。

High metastatic node number, not extranodal extension, as a node-related prognosticator in surgically treated patients with nodal metastatic salivary gland carcinoma.

机构信息

Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, Republic of China.

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.

出版信息

Head Neck. 2019 Jun;41(6):1572-1582. doi: 10.1002/hed.25603. Epub 2019 Jan 16.

Abstract

BACKGROUND

The prognostic relevance of extranodal extension (ENE) for salivary gland carcinoma (SGC) remains unclear. The present study is undertaken to investigate the predictive significance of pathological nodal parameters in surgically treated patients with nodal metastatic SGC.

METHODS

This multicenter cohort included 114 patients with pathologically proven node-positive SGC between 2000 and 2014. Possible correlations of clinicopathological parameters and outcomes were examined.

RESULTS

The median follow-up was 69 months (range, 11-173 months). The multivariate analysis identified metastatic node number (1-2 vs 3-6; 1-2 vs ≥7) as an independent predictor for regional control (P = 0.005; P = 0.02), locoregional control (P = 0.008; P = 0.04), distant metastasis-free survival (P = 0.17; P = 0.006), disease-free survival (P = 0.05; P = 0.002), and overall survival (P = 0.18; P = 0.009), whereas ENE was not associated with survival outcomes.

CONCLUSIONS

Metastatic node number, not ENE, is an independent node-related prognosticator for SGC. Integration of ENE into the American Joint Committee on Cancer 8th edition staging criteria may not improve prognostic performance.

摘要

背景

外侵犯(ENE)对唾液腺癌(SGC)的预后相关性尚不清楚。本研究旨在探讨病理淋巴结参数在手术治疗淋巴结转移 SGC 患者中的预测意义。

方法

本多中心队列纳入了 2000 年至 2014 年间经病理证实的淋巴结阳性 SGC 患者 114 例。对临床病理参数与预后的可能相关性进行了研究。

结果

中位随访时间为 69 个月(范围,11-173 个月)。多因素分析确定转移淋巴结数量(1-2 枚与 3-6 枚;1-2 枚与≥7 枚)是区域控制(P=0.005;P=0.02)、局部区域控制(P=0.008;P=0.04)、无远处转移生存(P=0.17;P=0.006)、无病生存(P=0.05;P=0.002)和总生存(P=0.18;P=0.009)的独立预测因素,而 ENE 与生存结果无关。

结论

转移淋巴结数量,而不是 ENE,是 SGC 的独立淋巴结预后预测因子。将 ENE 纳入美国癌症联合委员会第 8 版分期标准可能不会改善预后性能。

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