阳性淋巴结数量优于第 8 版 AJCC 的颈部分期，可预测腮腺黏液表皮样癌的预后。

Number of positive lymph nodes is superior to neck stage of the 8th AJCC in predicting prognosis in parotid mucoepidermoid carcinoma.

机构信息

Department of Oral Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Head Neck. 2023 Oct;45(10):2613-2618. doi: 10.1002/hed.27486. Epub 2023 Aug 18.

DOI:10.1002/hed.27486

PMID:37594176

Abstract

BACKGROUND

To clarify the impact of the number of positive lymph nodes (LNs) on the prognosis of parotid mucoepidermoid carcinoma (MEC).

METHODS

Patients who underwent neck dissection for parotid MEC were retrospectively enrolled. The primary outcome variable was overall survival (OS). Associations between OS and LN factors, including the AJCC N stage, intraparotid LN metastasis, number of positive LNs, LN size, and extranodal extension (ENE), were evaluated using Cox proportional hazard regression analyses.

RESULTS

A total of 720 patients were included with a mean age of 56 ± 16 years. There was no additional survival compromise until two positive LNs were presented. After adjusting for the number of positive LNs, intraparotid LN metastasis, ENE, and LN size were not related to prognosis. Our proposed N stage based on the number of metastatic LNs (0/1 vs. 2-4 vs. 5+) showed a superior C-index to the AJCC N stage in OS prediction.

CONCLUSION

Quantitative LN burden was an important determinant of prognosis, and the proposed N stage provided better OS stratification than the AJCC N stage.

摘要

背景

为了阐明阳性淋巴结（LNs）数量对腮腺黏液表皮样癌（MEC）预后的影响。

方法

回顾性纳入接受腮腺 MEC 颈部清扫术的患者。主要结局变量为总生存期（OS）。使用 Cox 比例风险回归分析评估 OS 与 LN 因素（包括 AJCC N 分期、腮腺内 LN 转移、阳性 LNs 数量、LN 大小和淋巴结外扩展（ENE））之间的相关性。

结果

共纳入 720 例患者，平均年龄为 56±16 岁。直到出现两个阳性 LNs 才会导致生存状况进一步恶化。在调整阳性 LNs 数量、腮腺内 LN 转移、ENE 和 LN 大小时，AJCC N 分期与预后无关。我们提出的基于转移 LNs 数量的 N 分期（0/1 对 2-4 对 5+）在 OS 预测中比 AJCC N 分期具有更高的 C 指数。