Han Feng
Department of Pediatric Dentistry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Front Oncol. 2023 Mar 23;13:1153186. doi: 10.3389/fonc.2023.1153186. eCollection 2023.
Survival significance of the number of positive lymph nodes (LNs) in parotid adenoid cystic carcinoma (ACC) remains unknown; thus, this study aimed to determine the impact of the number of positive LNs on the prognosis of parotid ACC.
Patients with surgically treated parotid ACC were enrolled from the SEER database. The number of positive LNs was analyzed using three models (0 vs 1+, 0 vs 1 vs 2 vs 3 vs 4 vs 4 vs 5 vs 6+, 0/1 vs 2-4 vs 5+), its hazard ratios on disease specific survival (DSS) and overall survival (OS) were assessed using univariate and multivariate Cox analyses.
A total of 1,689 patients were included. In all models, the number of positive LNs was independently related to DSS and OS, model 3 had the highest C-index for DSS [0.83 (95% CI: 0.81-0.85)] and OS [0.82 (95% CI: 0.80-0.84)]. Compared with the 0/1 positive LN group, the 2-4 positive LN group had an HR of 2.81 (95% CI: 1.73-4.56) for DSS and 2.36 (95% CI: 1.58-3.54) for OS. The 5+ LN group had an HR of 20.15 (95% CI: 7.50-54.18) for DSS and 14.20 (95% CI: 5.45-36.97) for OS. No overlap existed in the 95% CI of the HR.
The three prognostic categories based on the number of positive LNs (0/1 vs 2-4 vs 5+) could stratify the DSS and OS in parotid ACC without overlap.
腮腺腺样囊性癌（ACC）中阳性淋巴结（LN）数量的生存意义尚不清楚；因此，本研究旨在确定阳性LN数量对腮腺ACC预后的影响。
从监测、流行病学和最终结果（SEER）数据库中纳入接受手术治疗的腮腺ACC患者。使用三种模型分析阳性LN数量（0对1+、0对1对2对3对4对4对5对6+、0/1对2 - 4对5+），通过单因素和多因素Cox分析评估其对疾病特异性生存（DSS）和总生存（OS）的风险比。
共纳入1689例患者。在所有模型中，阳性LN数量均与DSS和OS独立相关，模型3对DSS的C指数最高[0.83（95%可信区间：0.81 - 0.85）]，对OS的C指数为[0.82（95%可信区间：0.80 - 0.84）]。与0/1个阳性LN组相比，2 - 4个阳性LN组的DSS风险比为2.81（95%可信区间：1.73 - 4.56），OS风险比为2.36（95%可信区间：1.58 - 3.54）。5个及以上LN组的DSS风险比为20.15（95%可信区间：7.50 - 54.18），OS风险比为14.20（95%可信区间：5.45 - 36.97）。风险比的95%可信区间不存在重叠。
基于阳性LN数量的三种预后分类（0/1对2 - 4对5+）可对腮腺ACC的DSS和OS进行分层，且无重叠。
