Laughlin Brady S, Ebrahimi Sasha, Voss Molly M, Patel Samir H, Foote Robert L, McGee Lisa A, Garcia Joaquin, Ma Daniel J, Garces Yolanda I, Wittich Michelle A Neben, Price Katharine A, Schmitt Alessandra, Zhai Qihui, May Byron C, Nagel Thomas H, Hinni Michael L, Chintakuntlawar Ashish V, DeWees Todd A, Rwigema Jean-Claude M
Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona.
Transitional Year Residency Program, Riverside Community Hospital, Riverside, California.
Adv Radiat Oncol. 2023 Mar 1;8(4):101204. doi: 10.1016/j.adro.2023.101204. eCollection 2023 Jul-Aug.
This series reports long-term clinical outcomes of patients with salivary duct carcinoma (SDC), which is associated with a poor prognosis.
Eighty-nine patients with SDC were treated with curative intent from February 5, 1971, through September 15, 2018. Kaplan-Meier and competing risk analyses were used to estimate locoregional control, distant metastasis-free survival (DMFS), progression-free survival, and overall survival (OS). Cox regression analyses of disease and treatment characteristics were performed to discover predictors of locoregional control, DMFS, and OS.
Median follow-up was 44.1 months (range, 0.23-356.67). The median age at diagnosis was 66 years (interquartile range, 57-75). Curative surgery followed by adjuvant radiation therapy was performed in 73 patients (82%). Chemotherapy was delivered in 26 patients (29.2%). The 5-year local recurrence and distant metastasis rates were 27% and 44%, respectively, with death as a competing risk. Distant metastasis was associated with lymph node-positive disease (hazard ratio [HR], 3.16; 95% confidence interval [CI], 1.38-7.23; = .006), stage IV disease (HR, 4.78; 95% CI, 1.14-20.11; = .033), perineural invasion (HR, 4.56; 95% CI, 1.74-11.97; = .002), and positive margins (HR, 9.06; 95% CI, 3.88-21.14; < .001). Median OS was 4.84 years (95% CI, 3.54-7.02). The 5-year OS was 42%. Reduced OS was associated with lymphovascular space invasion (HR, 3.49; 95% CI, 1.2-10.1; = .022), perineural invasion (HR, 2.05; 95% CI, 1.06-3.97; = .033), positive margins (HR, 2.7; 95% CI, 1.3-5.6; = .011), N2 disease (HR, 1.88; 95% CI, 1.03-3.43; = .04), and N3 disease (HR, 11.76; 95% CI, 3.19-43.3; < .001).
In this single-institution, multicenter retrospective study, the 5-year survival was 42% in patients with SDC. Lymphovascular space invasion, lymph node involvement, and higher staging at diagnosis were associated with lower DMFS and OS.
本系列报告涎腺导管癌（SDC）患者的长期临床结局，该疾病预后较差。
1971年2月5日至2018年9月15日期间，89例SDC患者接受了根治性治疗。采用Kaplan-Meier法和竞争风险分析来评估局部区域控制、无远处转移生存期（DMFS）、无进展生存期和总生存期（OS）。对疾病和治疗特征进行Cox回归分析，以发现局部区域控制、DMFS和OS的预测因素。
中位随访时间为44.1个月（范围0.23 - 356.67个月）。诊断时的中位年龄为66岁（四分位间距57 - 75岁）。73例患者（82%）接受了根治性手术，随后进行辅助放疗。26例患者（29.2%）接受了化疗。5年局部复发率和远处转移率分别为27%和44%，死亡作为竞争风险。远处转移与淋巴结阳性疾病（风险比[HR]，3.16；95%置信区间[CI]，1.38 - 7.23；P = 0.006）、IV期疾病（HR，4.78；95% CI，1.14 - 20.11；P = 0.033）、神经周围侵犯（HR，4.56；95% CI，1.74 - 11.97；P = 0.002）和切缘阳性（HR，9.06；95% CI，3.88 - 21.14；P < 0.001）相关。中位OS为4.84年（95% CI，3.54 - 7.02）。5年OS为42%。OS降低与脉管间隙侵犯（HR，3.49；95% CI，1.2 - 10.1；P = 0.022）、神经周围侵犯（HR，2.05；95% CI，1.06 - 3.97；P = 0.033）、切缘阳性（HR，2.7；95% CI，1.3 - 5.6；P = 0.011）、N2期疾病（HR，1.88；95% CI，1.03 - 3.
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