Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, 147 Boulevard Baille, 13005, Marseille, France; Aix Marseille Univ, Marseille, France; REFCOR (Réseau d'Expertise Français sur Les Cancers ORL Rares), Paris, France.
Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de L'Information et de La Communication, Marseille, France.
Eur J Surg Oncol. 2021 Jun;47(6):1376-1383. doi: 10.1016/j.ejso.2020.11.123. Epub 2020 Nov 21.
To describe the characteristics of the largest European study of MEC of salivary glands and to determine the prognostic factors for overall and disease free survival.
Patients with MEC were prospectively included in the Réseau d'Expertise Français sur les Cancers ORL Rares (REFCOR, French Network of Rare Head and Neck Tumors) database between 2009 and 2015.
A total of 292 patients were included. Tumors were classified as low grade in 175 cases (60%), intermediate in 39 (13%) and high grade in 78 (27%). Median follow-up was 26 months. The 5-year OS and DFS rates were respectively 83% and 69%. In multivariate analysis, age (p = 0.004), diabetes (p = 0.02) and advanced stage (p = 0.03) were found to have a significant negative impact on OS. Diabetes (p = 0.001), alcohol consumption (p = 0.003) and advanced stage (p = 0.001) were found to have a significant negative impact on DFS. Compare to low grade, high grade tended to have a negative impact on OS (p = 0.05) and had a significant effect on DFS (0.002) while intermediate grade had no significant influence on survival. The surgical treatment had a positive impact on both OS (p = 0.00005) and DFS (p = 0.0005). Postoperative radiotherapy had no impact in multivariate analysis.
Advanced clinical stage, high grade tumor, high age, the impossibility of carrying out a complete surgical resection, and diabetes are the main prognostic factors in this prospective series of patients with MEC. Such findings open new research perspectives on the influence of these components on initial patient care.
描述欧洲最大的唾液腺癌 MEC 研究的特点,并确定总生存和无病生存的预后因素。
2009 年至 2015 年期间,患者前瞻性纳入法国头颈部罕见肿瘤网络(REFCOR)数据库。
共纳入 292 例患者。肿瘤低级别 175 例(60%),中级别 39 例(13%),高级别 78 例(27%)。中位随访时间为 26 个月。5 年 OS 和 DFS 率分别为 83%和 69%。多因素分析显示,年龄(p=0.004)、糖尿病(p=0.02)和晚期(p=0.03)与 OS 显著负相关。糖尿病(p=0.001)、酒精摄入(p=0.003)和晚期(p=0.001)与 DFS 显著负相关。与低级别相比,高级别肿瘤对 OS 有负面影响(p=0.05),对 DFS 有显著影响(p=0.002),而中级别对生存无显著影响。手术治疗对 OS(p=0.00005)和 DFS(p=0.0005)均有积极影响。多因素分析中,术后放疗无影响。
在本前瞻性 MEC 患者系列中,高级别肿瘤、高级别肿瘤、高龄、无法进行完全手术切除、糖尿病是主要的预后因素。这些发现为这些因素对初始患者治疗的影响开辟了新的研究前景。