Cruz Andreia, Magalhães Helena, Pereira Filipa Ferreira, Dinis José, Vieira Cláudia
Medical Oncology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.
Medical Oncology Department, Unidade Local de Saúde de Matosinhos - Hospital Pedro Hispano, Matosinhos, Portugal.
Ecancermedicalscience. 2020 Jun 12;14:1055. doi: 10.3332/ecancer.2020.1055. eCollection 2020.
Primary salivary gland cancers comprise a heterogeneous group of histological entities and represent less than 5% of head and neck malignancies. Surgical resection is the main treatment, and adjuvant radiotherapy is performed in selected cases. Chemotherapy is an option in metastatic or recurrent disease, with poor evidence. We aimed to review a 10-year experience of a cancer centre on major salivary gland cancers, focusing on clinical, pathological, treatment and patients' outcomes data. A total of 93 patients were identified, median age at diagnosis was 64 years (IQR, 23), and 51.6% were male. The parotid gland was the site of origin in 76.3% of cases. The most frequent histological type was salivary duct carcinoma (21.5%). All patients were submitted to surgery and adjuvant radiotherapy was performed in 74.2%. From 26 patients diagnosed with metastatic disease, 9 were treated with systemic therapy. At 8 years, disease-free survival was 54.6% and overall survival was 48.4%. Male sex, salivary duct carcinoma, stage pT3-4, stage pN2-3, high histologic grade, lymphovascular invasion and perineural invasion were negative prognostic indicators for disease-free survival and overall survival. Extracapsular spread was a negative prognostic indicator for overall survival. In the multivariable analysis, histological type-salivary duct carcinoma-kept significant negative impact in disease-free survival and high histologic grade in overall survival. The most frequent histological type was salivary duct carcinoma, which is estimated to represent only 9% of salivary tumours. Patients with salivary duct carcinoma relapsed more than other histological types. High histologic grade was a negative prognostic indicator for overall survival.
原发性涎腺癌由一组组织学类型各异的实体组成，占头颈部恶性肿瘤的比例不到5%。手术切除是主要治疗方法，部分病例需进行辅助放疗。化疗适用于转移性或复发性疾病，但证据不足。我们旨在回顾一家癌症中心10年来对主要涎腺癌的治疗经验，重点关注临床、病理、治疗及患者预后数据。共纳入93例患者，诊断时的中位年龄为64岁（四分位间距为23岁），男性占51.6%。76.3%的病例起源于腮腺。最常见的组织学类型是涎腺导管癌（21.5%）。所有患者均接受了手术，74.处理。在26例诊断为转移性疾病的患者中，9例接受了全身治疗。8年时，无病生存率为54.6%，总生存率为48.4%。男性、涎腺导管癌、pT3 - 4期、pN2 - 3期、高组织学分级、淋巴管浸润和神经周围浸润是无病生存率和总生存率的不良预后指标。包膜外扩散是总生存率的不良预后指标。在多变量分析中，组织学类型——涎腺导管癌——对无病生存率仍有显著负面影响，高组织学分级对总生存率有显著负面影响。最常见的组织学类型是涎腺导管癌，据估计仅占涎腺肿瘤的9%。涎腺导管癌患者比其他组织学类型更容易复发。高组织学分级是总生存率的不良预后指标。 2%的患者接受了辅助放疗。26例诊断为转移性疾病的患者中，9例接受了全身治疗。8年时，无病生存率为54.6%，总生存率为48.4%。男性、涎腺导管癌、pT3 - 4期、pN2 - 3期、高组织学分级、淋巴管浸润和神经周围浸润是无病生存率和总生存率的不良预后指标。包膜外扩散是总生存率的不良预后指标。在多变量分析中，组织学类型——涎腺导管癌——对无病生存率仍有显著负面影响，高组织学分级对总生存率有显著负面影响。最常见的组织学类型是涎腺导管癌，据估计仅占涎腺肿瘤的9%。涎腺导管癌患者比其他组织学类型更容易复发。高组织学分级是总生存率的不良预后指标。
