Zhang Di, Li Lixi, Wen Tingyu, Ma Fei
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Panjiayuan nan Road 17, Beijing, 100021, China.
Eur Arch Otorhinolaryngol. 2023 Jan;280(1):409-417. doi: 10.1007/s00405-022-07599-x. Epub 2022 Aug 29.
To explore the clinical characteristics, prognostic factors, and value of adjuvant therapy for major salivary duct carcinoma (SDC).
Data of SDC patients who received surgery was obtained from Surveillance, Epidemiology, and End Results (SEER) database (2004-2016). Kaplan-Meier and Cox regression analyses were performed to assess prognostic factors. Propensity score matching (PSM) was done to evaluate the clinical value of adjuvant therapy.
A total of 287 patients were enrolled. The 5-year overall survival (OS) and disease-specific survival (DSS) rates were 53.8% and 70.8%, respectively. In the univariate analysis, tumor size, T, N, TNM staging, SEER combined staging, number of regional lymph nodes examined, and number of positive lymph nodes were associated with OS and DSS. Age and primary surgical methods were also related to OS. Among patients with negative lymph nodes, patients with tumor size > 4 cm had significantly worse prognosis (P = 0.009). Multivariate analysis showed that age > 75 years, T3-4, and positive lymph nodes were independent risk factors for SDC. After PSM, the prognostic factors were age, tumor site, and T and N stage. Postoperative radiotherapy could improve OS in patients with tumor size > 4 cm (P = 0.049).
Advanced age, submandibular gland lesions, T3-4 stage, and lymph node involvement were independent prognostic factors for SDC. In patients with tumors > 4 cm, adjuvant radiotherapy improved the OS of SDC patients.
探讨大涎腺导管癌（SDC）的临床特征、预后因素及辅助治疗的价值。
从监测、流行病学和最终结果（SEER）数据库（2004 - 2016年）获取接受手术治疗的SDC患者的数据。进行Kaplan - Meier和Cox回归分析以评估预后因素。采用倾向评分匹配（PSM）来评估辅助治疗的临床价值。
共纳入287例患者。5年总生存率（OS）和疾病特异性生存率（DSS）分别为53.8%和70.8%。单因素分析中，肿瘤大小、T、N、TNM分期、SEER综合分期、检查的区域淋巴结数量及阳性淋巴结数量与OS和DSS相关。年龄和初次手术方式也与OS有关。在淋巴结阴性的患者中，肿瘤大小>4 cm的患者预后明显更差（P = 0.009）。多因素分析显示，年龄>75岁、T3 - 4和阳性淋巴结是SDC的独立危险因素。PSM后，预后因素为年龄、肿瘤部位以及T和N分期。术后放疗可改善肿瘤大小>4 cm患者的OS（P = 0.049）。
高龄、下颌下腺病变、T3 - 4期和淋巴结受累是SDC的独立预后因素。对于肿瘤>4 cm的患者，辅助放疗可改善SDC患者的OS。
