Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Oral Oncol. 2020 Aug;107:104780. doi: 10.1016/j.oraloncology.2020.104780. Epub 2020 May 19.
Due to the rarity of low-grade parotid gland cancer and the diversity of histologic subtype, its optimal treatment modalities and prognostic factors have not been established yet. In this study, we aimed to identify the prognostic factors and adequate treatment modalities for patients with low-grade parotid gland cancer.
We retrospectively analyzed clinico-pathologic data from 287 patients with low-grade parotid gland cancer from 1999 to 2018.
Recurrence-free survival, disease-specific survival, and overall survival rates at 10 years were 80.6%, 93.9%, and 84.4%, respectively. Among all patients, 56.1% received surgery alone, and the remaining 43.9% received surgery with adjuvant radiotherapy. Resection margin status and TNM stage were significant unfavorable prognostic factors. In patients with T1-2 tumor, surgical extent (total vs. less-than-total) did not show any significant effect on disease recurrence and patients' survival, and the disease was controlled well if a negative surgical margin was obtained after surgery, even with microscopic clear margin of<1 mm. In patients with adverse pathologic features (positive margin, lymphovascular invasion, perineural invasion, extracapsular nodal spread, T3-4, and N1-3), adjuvant radiotherapy significantly decreased loco-regional recurrence.
Oncological outcomes were good in patients with low-grade parotid gland cancer with surgery and radiotherapy. In patients with T1-2 low-grade parotid gland cancer, surgery alone showed good local control rate regardless of the extent of surgery, if a negative surgical margin was obtained after surgery. Adjuvant radiotherapy played a significant role in controlling loco-regional recurrence in patients with adverse pathologic features.
由于低级别腮腺癌的罕见性和组织学亚型的多样性，其最佳治疗方式和预后因素尚未确定。本研究旨在确定低级别腮腺癌患者的预后因素和适当的治疗方式。
我们回顾性分析了 1999 年至 2018 年 287 例低级别腮腺癌患者的临床病理资料。
10 年无复发生存率、疾病特异性生存率和总生存率分别为 80.6%、93.9%和 84.4%。所有患者中，56.1%单独接受手术治疗，其余 43.9%接受手术加辅助放疗。切缘状态和 TNM 分期是显著的不良预后因素。在 T1-2 肿瘤患者中，手术范围（全切除与不全切除）对疾病复发和患者生存无显著影响，如果手术后获得阴性切缘，即使切缘<1mm 有镜下残留，疾病也能得到很好的控制。在具有不良病理特征（阳性切缘、脉管侵犯、神经周围侵犯、包膜外淋巴结转移、T3-4 和 N1-3）的患者中，辅助放疗显著降低局部区域复发率。
对于接受手术和放疗的低级别腮腺癌患者，肿瘤学结果良好。对于 T1-2 级低级别腮腺癌患者，如果手术后获得阴性切缘，无论手术范围如何，单独手术都显示出良好的局部控制率。在具有不良病理特征的患者中，辅助放疗在控制局部区域复发方面发挥了重要作用。
