Zhao Ying, He Guosheng, Zhai Yirui, Zhou Zongmei, Bi Nan, Mao Yousheng, Zhang Yi, Xiao Zefen, Gao Shugeng, Lv Jima, Xue Qi, Feng Qinfu
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Ann Surg Oncol. 2022 Mar 30. doi: 10.1245/s10434-022-11590-5.
Pulmonary adenoid cystic carcinoma (ACC) is a rare type of lung malignancy. The prevalence of ACC of lobar bronchial origin is lower than that of other lung malignancies, and studies investigating it are lacking. This study aimed to evaluate survival of patients with ACC of the lobar bronchus after surgical resection and to explore its prognostic factors.
Between January 2000 and December 2019, 35 patients at the National Cancer Center/Cancer Hospital with a diagnosis of ACC of the lobar bronchus were included in the retrospective analysis.
During a median follow-up period of 61 months (range, 10-194 months), the analysis showed a 5-year overall survival (OS) rate of 81.4%, a 5-year locoregional recurrence-free survival rate of 84.0%, and 5-year disease-free survival rate of 60.1%. The univariate analysis exclusively identified the surgical margin as a predictor of OS, and survival was significantly longer for the patients with negative surgical margins than for those with positive surgical margins (R0 vs. R1: 94.4% vs. 66.0%; p = 0.014). Adjuvant radiotherapy was administered to most of the patients with positive surgical margins, which might have contributed to prolonged OS (R0 vs. R1+RT: 94.4% vs. 66.7%, p = 0.173; R0 vs. R1+no RT: 94.4% vs. 62.5%, p = 0.007).
For ACC of lobar bronchial origin, complete resection is the radical treatment, and the OS rate was significantly higher for the R0 patients than for the R1 patients. Adjuvant radiotherapy for patients with R1 may prolong survival.
肺腺样囊性癌（ACC）是一种罕见的肺恶性肿瘤。叶支气管起源的ACC患病率低于其他肺恶性肿瘤，且缺乏相关研究。本研究旨在评估叶支气管ACC患者手术切除后的生存率，并探讨其预后因素。
2000年1月至2019年12月期间，对国家癌症中心/癌症医院35例诊断为叶支气管ACC的患者进行回顾性分析。
中位随访期61个月（范围10 - 194个月），分析显示5年总生存率（OS）为81.4%，5年局部区域无复发生存率为84.0%，5年无病生存率为60.1%。单因素分析仅确定手术切缘是OS的预测因素，手术切缘阴性患者的生存时间显著长于切缘阳性患者（R0 vs. R1：94.4% vs. 66.0%；p = 0.014）。大多数手术切缘阳性的患者接受了辅助放疗，这可能有助于延长OS（R0 vs. R1+放疗：94.4% vs. 66.7%，p = 0.173；R0 vs. R1+未放疗：94.4% vs. 62.5%，p = 0.007）。
对于叶支气管起源的ACC，完整切除是根治性治疗，R0患者的OS率显著高于R1患者。R1患者接受辅助放疗可能延长生存期。
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