Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Laryngoscope. 2020 May;130(5):E335-E339. doi: 10.1002/lary.28183. Epub 2019 Jul 10.
OBJECTIVES/HYPOTHESIS: Carcinosarcomas represent a rare entity of mixed malignant tumors of the salivary gland with limited evidence regarding management strategies. We aim to demonstrate the incidence, prognostic factors, and conduct a survival analysis for this aggressive malignancy.
Retrospective database review.
The Surveillance, Epidemiology, and End Results database was queried for all cases of major salivary carcinosarcoma and its incidence from 1973 to 2015 to identify 66 patients.
The incidence of this tumor was 0.02 cases per 1 million, with a rising number of absolute cases in the past 2 decades. The parotid gland was the most common site (78.8%) of involvement. The 5-year overall survival was 37% and 5-year disease-specific survival was 62%. Surgery was most common management strategy (95.5%), with total parotidectomy and facial nerve sacrifice procedures for those with parotid disease. Radiotherapy was commonly performed (75.8%) and chemotherapy use was rare (18.2%). Patients with distant metastasis had a greater than threefold increase in mortality, and those with total parotidectomy surgery had decreased mortality.
Carcinosarcomas of major salivary glands are extremely rare and highly aggressive tumors. We recommend prompt surgical management and postoperative radiation for this tumor with a poor prognosis.
NA Laryngoscope, 130:E335-E339, 2020.
目的/假设：癌肉瘤是一种罕见的混合恶性唾液腺肿瘤，关于其治疗策略的证据有限。我们旨在展示这种侵袭性恶性肿瘤的发病率、预后因素，并进行生存分析。
回顾性数据库研究。
查询 1973 年至 2015 年期间监测、流行病学和最终结果数据库中所有主要唾液腺癌肉瘤及其发病率的病例，以确定 66 例患者。
这种肿瘤的发病率为每 100 万人中有 0.02 例，在过去 20 年中绝对病例数呈上升趋势。腮腺是最常见的受累部位（78.8%）。5 年总生存率为 37%，5 年疾病特异性生存率为 62%。手术是最常见的治疗策略（95.5%），对于腮腺疾病患者，采用全腮腺切除术和面神经牺牲术。放射治疗普遍进行（75.8%），化疗应用很少（18.2%）。有远处转移的患者死亡率增加了三倍以上，而接受全腮腺切除术的患者死亡率降低。
大唾液腺癌肉瘤是非常罕见且高度侵袭性的肿瘤。我们建议对这种预后不良的肿瘤进行及时的手术治疗和术后放疗。
无 喉科学，130：E335-E339，2020 年。
