School of Clinical Stomatology, Tianjin Medical University, Tianjin, China.
School of Clinical Stomatology, Nankai University, Tianjin, China.
Eur Arch Otorhinolaryngol. 2022 Aug;279(8):4093-4102. doi: 10.1007/s00405-022-07269-y. Epub 2022 Jan 23.
To further explore the clinicopathological characteristics and determinants of survival of patients with HNMC.
The Surveillance, Epidemiology and End Results (SEER) database was used to collect the data of patients diagnosed with HNMC from 1975 to 2016. Kaplan-Meier analysis and log-rank testing compared the survival difference. Cox hazard regression models analyzed the survival outcome and prognostic factors. Concordance index (C-index) verified the nomogram.
A total of 322 eligible cases were retrieved. The mean age at diagnosis was 61 years old and the male to female ratio was 1:1. The major salivary gland was the most common primary site (72.5%). Patients with adjuvant radiation showed better overall survival (OS) (P < 0.05). Advanced grade, N, M stage and nonsurgery contributed independently to shorter OS, while the advanced N, M stage and nonsurgery contributed independently to shorter disease-specific survival (DSS) (P < 0.05). The C-index of OS-specific nomogram was 0.768 (95% CI 0.726-0.810).
HNMC usually appears in elderly patients and has no gender difference. The 5-year OS and DSS rates are 70% and 79.8%, respectively. Grade, N, M stage and surgery are independent prognostic factors for OS, while N, M stage and surgery are independent prognostic factors for DSS. Compared with the surgery alone, adjuvant radiation appears to offer a significant OS benefit for patients with stage III or IV.
进一步探讨 HNMC 患者的临床病理特征和生存决定因素。
利用监测、流行病学和最终结果（SEER）数据库收集 1975 年至 2016 年间诊断为 HNMC 的患者数据。Kaplan-Meier 分析和对数秩检验比较生存差异。Cox 风险回归模型分析生存结果和预后因素。一致性指数（C-index）验证了列线图。
共纳入 322 例符合条件的病例。诊断时的平均年龄为 61 岁，男女比例为 1:1。主要唾液腺是最常见的原发部位（72.5%）。接受辅助放疗的患者总体生存率（OS）更好（P<0.05）。高级别、N、M 期和非手术独立与 OS 较短相关，而高级别 N、M 期和非手术独立与疾病特异性生存率（DSS）较短相关（P<0.05）。OS 特异性列线图的 C-index 为 0.768（95%CI 0.726-0.810）。
HNMC 通常发生在老年患者中，且无性别差异。5 年 OS 和 DSS 率分别为 70%和 79.8%。分级、N、M 期和手术是 OS 的独立预后因素，而 N、M 期和手术是 DSS 的独立预后因素。与单独手术相比，III 期或 IV 期患者接受辅助放疗似乎能显著提高 OS。
