腮腺内淋巴结转移降低腮腺癌患儿的生存率。

Intraparotid Lymph Node Metastasis Decreases Survival in Pediatric Patients With Parotid Cancer.

作者信息

Seng Dongjie, Fang Qigen, Liu Fei, Luo Ruihua, Liu Shanting

机构信息

Professor, Department of Otorhinolaryngology, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, People's Republic of China.

Attending Physician, Department of Head and Neck, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People's Republic of China.

出版信息

J Oral Maxillofac Surg. 2020 May;78(5):852.e1-852.e6. doi: 10.1016/j.joms.2020.01.008. Epub 2020 Jan 17.

DOI:10.1016/j.joms.2020.01.008

PMID:32045566

Abstract

PURPOSE

The occurrence of parotid cancer in pediatric patients is uncommon, and the significance of intraparotid lymph node (IPN) metastasis in the pediatric population remains unknown. Therefore, the main goal of the present study was to analyze the effect of IPN metastasis on survival in pediatric patients with parotid cancer.

PATIENTS AND METHODS

Pediatric patients with parotid cancer were retrospectively enrolled from multiple medical centers. The association between IPN metastasis and clinicopathologic variables was analyzed using χ tests. The main study endpoint was recurrence-free survival (RFS), which was calculated using the Kaplan-Meier method. Independent prognostic factors were evaluated using the Cox proportional hazards method.

RESULTS

IPN metastasis was noted in 15 of 77 patients (19.5%). A positive relationship was noted between IPN metastasis and tumor stage, lymphoma history, and disease grade. The 10-year RFS was 91%. Univariate analysis revealed that IPN metastasis, disease grade, resection extent, tumor stage, and lymphoma history were associated with RFS. Cox regression analysis revealed that IPN metastasis (odds ratio [OR], 2.805; 95% confidence interval [CI], 1.697 to 5.119; P = .004) and lymphoma history (OR, 1.742; 95% CI, 1.027 to 3.687; P = .014) were the only 2 independent predictors of recurrence.

CONCLUSIONS

IPN metastasis significantly decreased survival in patients with pediatric parotid cancer.

摘要

目的

小儿腮腺癌的发生并不常见，腮腺内淋巴结（IPN）转移在小儿患者中的意义尚不清楚。因此，本研究的主要目的是分析IPN转移对小儿腮腺癌患者生存的影响。

患者与方法

从多个医疗中心回顾性纳入小儿腮腺癌患者。采用χ检验分析IPN转移与临床病理变量之间的关联。主要研究终点为无复发生存期（RFS），采用Kaplan-Meier方法计算。使用Cox比例风险法评估独立预后因素。

结果

77例患者中有15例（19.5%）出现IPN转移。IPN转移与肿瘤分期、淋巴瘤病史和疾病分级之间存在正相关关系。10年无复发生存率为91%。单因素分析显示，IPN转移、疾病分级、切除范围、肿瘤分期和淋巴瘤病史与无复发生存期相关。Cox回归分析显示，IPN转移（比值比[OR]，2.805；95%置信区间[CI]，1.697至5.119；P = 0.004）和淋巴瘤病史（OR，1.742；95% CI，1.027至3.687；P = 0.014）是仅有的2个复发独立预测因素。