腮腺原发性鳞状细胞癌：临床病理特征、治疗和预后。

Primary squamous cell carcinoma of the parotid gland: clinicopathological characteristics, treatment, and prognosis.

机构信息

National Clinical Research Centre for Oral Disease, Shanghai, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.

出版信息

Int J Oral Maxillofac Surg. 2021 Feb;50(2):151-157. doi: 10.1016/j.ijom.2020.06.010. Epub 2020 Jul 4.

DOI:10.1016/j.ijom.2020.06.010

PMID:32631631

Abstract

Squamous cell carcinoma (SCC) of the parotid gland is a rare aggressive malignancy with a poor prognosis. The clinical behaviour, histopathological characteristics, and treatment strategies for parotid SCC still need to be comprehensively demonstrated. In this study, a retrospective review of patients diagnosed with parotid SCC was performed, covering the past two decades. Twenty-nine patients with primary parotid SCC and 10 patients with recurrent parotid SCC were identified. The clinicopathological characteristics of parotid SCC were summarized. Imaging records were used to determine the extent of invasion of the parotid SCC. Histopathological alterations in the parotid resulting from the infiltration of SCC were demonstrated. A set of treatment strategies was developed, involving parotidectomy, neck dissection, facial nerve treatment, defect repair, adjuvant radiotherapy, and chemotherapy/targeted therapy. The median patient survival was 24 months for those with primary parotid SCC and 14.5 months for those with recurrent parotid SCC. Comparatively, patients with a larger tumour size of primary parotid SCC experienced poorer overall survival (hazard ratio 8.986; P=0.013). Great efforts have been made over the past two decades to identify and treat parotid SCC. Consensus regarding therapeutic options for parotid SCC has not been widely achieved and there is still a great need for well-designed prospective studies.

摘要

腮腺鳞状细胞癌（SCC）是一种罕见的侵袭性恶性肿瘤，预后较差。腮腺 SCC 的临床行为、组织病理学特征和治疗策略仍需要全面论证。本研究回顾性分析了过去 20 年来诊断为腮腺 SCC 的患者，共纳入 29 例原发性腮腺 SCC 患者和 10 例复发性腮腺 SCC 患者。总结了腮腺 SCC 的临床病理特征。使用影像学记录来确定腮腺 SCC 的侵袭范围。展示了 SCC 浸润引起的腮腺组织病理学改变。制定了一套治疗策略，包括腮腺切除术、颈淋巴结清扫术、面神经处理、缺损修复、辅助放疗和化疗/靶向治疗。原发性腮腺 SCC 患者的中位生存时间为 24 个月，复发性腮腺 SCC 患者为 14.5 个月。相比之下，原发性腮腺 SCC 患者肿瘤较大者总体生存较差（风险比 8.986；P=0.013）。在过去的 20 年中，人们一直在努力识别和治疗腮腺 SCC。腮腺 SCC 的治疗选择尚未达成共识，仍需要精心设计的前瞻性研究。