Laxague Francisco, Dzioba Agnieszka, Jasani Dhruv, Warner Andrew, Palma David A, Lang Pencilla, Venkatesan Varagur, Read Nancy, Nichols Anthony C, Fung Kevin, Yoo John, Mendez Adrian, MacNeil S Danielle
Department of Otolaryngology-Head and Neck Surgery, Western University, Ontari, London, Canada.
Department of Radiation Oncology, Western University, Ontari, London, Canada.
Laryngoscope. 2023 May;133(5):1163-1168. doi: 10.1002/lary.30289. Epub 2022 Jul 26.
We aimed to analyze risk factors associated with poor survival outcomes for metastatic cutaneous head-and-neck SCC to the parotid.
All patients undergoing surgery for metastatic cutaneous SCC to the parotid with curative intent between 2011 and 2018, were reviewed. Demographic and clinical characteristics were evaluated. Histopathological data including tumor size and histology, tumor grade, TNM stage, resection margins, lymphovascular invasion, and perineural invasion, were analyzed. Overall survival (OS), disease-specific survival (DSS), and freedom from locoregional recurrence (LRR) were assessed.
Ninety patients were included (mean age, 77 years; 75 men [83.3%]). A total parotidectomy was performed in 48 patients (53.3%), and 42 (46.7%) underwent a superficial parotidectomy. Seventy patients (77.8%) underwent adjuvant RT. The median follow-up was 31 months (20-39 months). Tumor volume ≥ 50 cm and a shorter RT duration (<20 days) were associated with reduced OS (p = 0.002 and p = 0.01, p = 0.02 and p = 0.009, respectively), and DSS (p = 0.004 and p = 0.02, p = 0.04 and p = 0.02, respectively) on univariable and multivariable analysis, respectively. Only a shorter RT duration was associated with worse freedom from LRR on univariable and multivariable analysis, (p = 0.04 and p < 0.001, respectively). However, with death as a competing risk, a shorter duration of RT was not significantly associated with freedom from LRR.
A shorter duration of adjuvant RT, and excised tumor volume ≥50 cm were predictive factors of reduced OS and DSS, and a shorter duration of RT was also associated with reduced freedom from LRR in patients with metastatic SCC to the parotid gland.
4 Laryngoscope, 133:1163-1168, 2023.
我们旨在分析转移性皮肤头颈部鳞状细胞癌累及腮腺时与生存结局不佳相关的危险因素。
回顾了2011年至2018年间所有接受手术治疗的转移性皮肤鳞状细胞癌累及腮腺且有治愈意图的患者。评估了人口统计学和临床特征。分析了组织病理学数据，包括肿瘤大小和组织学、肿瘤分级、TNM分期、手术切缘、脉管侵犯和神经周围侵犯。评估了总生存期（OS）、疾病特异性生存期（DSS）和无局部区域复发生存期（LRR）。
纳入90例患者（平均年龄77岁；75例男性[83.3%]）。48例患者（53.3%）行全腮腺切除术，42例（46.7%）行腮腺浅叶切除术。70例患者（77.8%）接受了辅助放疗。中位随访时间为31个月（20 - 39个月）。单因素分析和多因素分析显示，肿瘤体积≥50 cm和放疗时间较短（<20天）分别与OS降低（p = 0.002和p = 0.01，p = 0.02和p = 0.009）以及DSS降低（p = 0.004和p = 0.02，p = 0.04和p = 0.02）相关。单因素分析和多因素分析均显示，仅放疗时间较短与LRR降低相关（p = 0.04和p < 0.001）。然而，以死亡作为竞争风险时，放疗时间较短与LRR无显著相关性。
辅助放疗时间较短以及切除肿瘤体积≥50 cm是转移性皮肤鳞状细胞癌累及腮腺患者OS和DSS降低的预测因素，放疗时间较短也与LRR降低相关。
4 喉镜，133:1163 - 1168，2023年。
