前瞻性多中心 REFCOR 研究 470 例头颈部腺样囊性癌：流行病学和预后因素。

A prospective multicentre REFCOR study of 470 cases of head and neck Adenoid cystic carcinoma: epidemiology and prognostic factors.

机构信息

Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 Rue de La Chine, 75020, Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France.

Department of Biopathology, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805, Villejuif, France.

出版信息

Eur J Cancer. 2020 May;130:241-249. doi: 10.1016/j.ejca.2020.01.023. Epub 2020 Mar 11.

DOI:10.1016/j.ejca.2020.01.023

PMID:32171628

Abstract

BACKGROUND

Adenoid cystic carcinoma (ACC) accounts for 1% of malignant head and neck tumours [1] and 10% of salivary glands malignant tumours. The main objective of our study is to investigate the prognostic factors influencing the event-free survival (EFS) of patients with ACC.

PATIENTS AND METHODS

A multicentre prospective study was conducted from 2009 to 2018. All 470 patients with ACC whose survival data appear in the REFCOR database were included in the study. The main judgement criterion was EFS. Both a bivariate survival analysis using log-rank test and a multivariate using Cox model were performed using the R software.

RESULTS

Average age was 55 years. Females accounted for 59.4% of the cohort. The body mass index (BMI) was normal in 86% of cases. Tumours were located in minor salivary glands in 60% of cases. T3/T4 stages represented 58%; 89% of patients were cN0. histological grade III was observed on 21% of patients. The EFS and overall 5-year survival rates were 50% and 85%, respectively. After adjustment, the most significant pejorative prognostic factors were age ≥65 years (hazard ratio [HR] = 1.67), BMI<16.5 (HR = 2.62), and lymph node invasion cN (HR = 2.08).

CONCLUSION

Age, BMI and N stage are the three main clinical prognostic factors determining EFS identified in this prospective series of patients with ACC. Such findings open new research perspectives on the influence of these components on initial patient care.

摘要

背景

腺样囊性癌（ACC）占头颈部恶性肿瘤的 1%[1]，占唾液腺恶性肿瘤的 10%。我们研究的主要目的是探讨影响腺样囊性癌患者无事件生存（EFS）的预后因素。

患者和方法

进行了一项多中心前瞻性研究，时间为 2009 年至 2018 年。所有在 REFCOR 数据库中生存数据的 470 例 ACC 患者均纳入本研究。主要判断标准是 EFS。使用 R 软件进行了双变量生存分析（log-rank 检验）和多变量 Cox 模型分析。

结果

平均年龄为 55 岁。女性占队列的 59.4%。86%的病例体重指数（BMI）正常。肿瘤位于小唾液腺的占 60%。T3/T4 期占 58%；89%的患者为 cN0。21%的患者组织学分级为 III 级。EFS 和总 5 年生存率分别为 50%和 85%。调整后，最显著的不良预后因素是年龄≥65 岁（风险比 [HR] = 1.67）、BMI<16.5（HR = 2.62）和淋巴结侵犯 cN（HR = 2.08）。