Park Song I, Park Woori, Choi Sungyong, Jang Yunjeong, Kim Hyunjin, Kim Seok-Hyung, Noh Jae Myoung, Chung Man Ki, Son Young-Ik, Baek Chung-Hwan, Jeong Han-Sin
Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Oncol. 2020 Jun 3;10:881. doi: 10.3389/fonc.2020.00881. eCollection 2020.
Salivary gland cancer (SGC) in the oral cavity is not common and has been less studied in comparison with oral squamous cell carcinoma (SCC). This study aimed to identify the clinical characteristics and outcomes of SGC in the oral cavity compared with oral SCC. The medical charts of the patients with SGC ( = 68) arising from minor salivary glands and SCC ( = 750) in the oral cavity between 1995 and 2017 were reviewed retrospectively. The clinical and pathological factors and treatment outcomes were compared to identify clinical differences between oral SGC and SCC in total cases and in tumor size and subsite (propensity score)-matched pairs ( = 68 in each group). In addition, pattern of local invasion was pathologically assessed in a subset of SGC and SCC tumors. Patients with SGC in the oral cavity showed >90% survival at 5 years. Most common pathologies of SGC were mucoepidermoid carcinoma (39.7%) and adenoid cystic carcinoma (35.3%), where high-grade tumors (including adenoid cystic carcinomas having solid components, grade 2 or 3) represented only 36.8%. Compared with oral SCC, surgery for SGC had narrow surgical safety margin. However, local control was very successful in SGC even with <5 mm or positive resection margin through surgery plus adjuvant radiation treatments or surgery alone for small low-grade tumors. Pathologic analysis revealed that the frequency of oral SGC with infiltrative tumor border was significantly lower than that of oral SCC (46.4 vs. 87.2%, < 0.001). SGC in the oral cavity represents relatively good prognosis and has a locally less aggressive pathology compared with oral SCC. Adjuvant radiation can be very effective to control minimal residual disease in oral SGC. Our study proposed that a different treatment strategy for oral SGC would be reasonable in comparison with oral SCC.
口腔唾液腺癌（SGC）并不常见，与口腔鳞状细胞癌（SCC）相比，对其研究较少。本研究旨在确定口腔SGC与口腔SCC相比的临床特征和预后。回顾性分析了1995年至2017年间口腔小唾液腺来源的SGC患者（n = 68）和口腔SCC患者（n = 750）的病历。比较临床和病理因素及治疗结果，以确定口腔SGC和SCC在总病例数、肿瘤大小和亚部位（倾向评分）匹配对（每组n = 68）中的临床差异。此外，对一部分SGC和SCC肿瘤进行了局部浸润模式的病理评估。口腔SGC患者5年生存率>90%。SGC最常见的病理类型是黏液表皮样癌（39.7%）和腺样囊性癌（35.3%），其中高级别肿瘤（包括具有实性成分的腺样囊性癌，2级或3级）仅占36.8%。与口腔SCC相比，SGC手术的手术安全切缘较窄。然而，即使手术切缘<5 mm或为阳性，通过手术加辅助放疗或仅对小的低级别肿瘤进行手术，SGC的局部控制仍然非常成功。病理分析显示，具有浸润性肿瘤边界的口腔SGC的频率显著低于口腔SCC（46.4%对87.2%，P < 0.001）。与口腔SCC相比，口腔SGC预后相对较好，局部病理侵袭性较小。辅助放疗对控制口腔SGC中的微小残留病灶可能非常有效。我们的研究表明，与口腔SCC相比，针对口腔SGC采取不同的治疗策略是合理的。
