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唾液腺黏液表皮样癌:印度一家三级癌症中心的长期治疗结果

Mucoepidermoid Carcinoma of the Salivary Gland: Long Term Outcomes from a Tertiary Cancer Center in India.

作者信息

Singareddy Rohith, Bajwa Harjot Kaur, Reddy Mahendra M, Alluri Krishnam Raju, Raju K V V N, Rao T Subramanyeshwar, Rao L M Chandrashekara

机构信息

Department of Radiation Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India.

Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital and Research Institute, Road No-10, Banjara Hills, Hyderabad, 500034 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1763-1767. doi: 10.1007/s12070-019-01781-0. Epub 2020 Jan 2.

Abstract

To analyze the patterns of failure and factors affecting recurrence and overall survival in mucoepidermoid carcinoma of the salivary gland. The hospital records were retrospectively analyzed from October 2010 to January 2016. Patients diagnosed as mucoepidermoid carcinoma of the salivary gland were eligible for analysis. All patients received surgery as the primary treatment modality with or without post operative radiotherapy. Statistical analysis for factors affecting recurrence was done by cox regression analysis and value less than 0.05 was considered significant. A total of 116 patients were diagnosed to have malignant salivary gland tumors of which 69 were mucoepidermoid carcinomas (69.5%). The median age was 43 years (8-75 years). Majority of the tumors occurred in major salivary glands gland (77%). 51% patients were females. Most common stage was stage II (36%) followed by stage I (27.5%), stage IV (20.3%) and stage III (16%). High grade carcinomas comprised 34.8%, intermediate grade 30.4% and low grade 34.8%. 36 patients (52.2%) received adjuvant radiotherapy (60 Gy in 30 fractions). At a median follow up of 42 months (8-70 months), 8 (11.6%) patients died (7 cancer related and 1 noncancer related). The locoregional recurrence rate was 4.3% whereas the distant metastasis rate was 11.6%. Most common site of distant metastasis was lung. The mean disease free survival time was 61.4 months and the mean overall survival was 62 months. On univariate analysis, age < 50 years, node positive, presence of PNI, high grade, presence of LVI and local recurrence were significant factors for distant metastasis ( < 0.05). On multivariate analysis, high grade, presence of LVI and local recurrence were significant factors for distant metastasis ( < 0.05). Mucoepidermoid carcinomas of salivary gland have good long term local control and overall survival. Majority of the recurrences are distant metastasis. High grade, LVI and local recurrence are significant risk factors for distant relapse.

摘要

分析涎腺黏液表皮样癌的失败模式以及影响复发和总生存的因素。对2010年10月至2016年1月的医院记录进行回顾性分析。诊断为涎腺黏液表皮样癌的患者符合分析条件。所有患者均接受手术作为主要治疗方式,部分患者术后接受或未接受放疗。采用Cox回归分析影响复发的因素,P值小于0.05被认为具有统计学意义。共有116例患者被诊断为涎腺恶性肿瘤,其中69例为黏液表皮样癌(69.5%)。中位年龄为43岁(8 - 75岁)。大多数肿瘤发生于大涎腺(77%)。51%的患者为女性。最常见的分期为Ⅱ期(36%),其次是Ⅰ期(27.5%)、Ⅳ期(20.3%)和Ⅲ期(16%)。高分化癌占34.8%,中分化癌占30.4%,低分化癌占34.8%。36例患者(52.2%)接受了辅助放疗(30次分割,共60 Gy)。中位随访42个月(8 - 70个月),8例患者(11.6%)死亡(7例与癌症相关,1例与非癌症相关)。局部区域复发率为4.3%,远处转移率为11.6%。最常见的远处转移部位是肺。平均无病生存时间为61.4个月,平均总生存时间为62个月。单因素分析显示,年龄<50岁、淋巴结阳性、存在神经侵犯、高分化、存在脉管侵犯和局部复发是远处转移的显著因素(P<0.05)。多因素分析显示,高分化、存在脉管侵犯和局部复发是远处转移的显著因素(P<0.05)。涎腺黏液表皮样癌具有良好的长期局部控制和总生存。大多数复发为远处转移。高分化、脉管侵犯和局部复发是远处复发的显著危险因素。

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