Han Ethan J, Mukdad Laith A, Alhiyari Yazeed, Nakhla Morcos N, Sajed Dipti P, St John Maie A
Department of Head & Neck Surgery UCLA Los Angeles California USA.
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine University of California Los Angeles California USA.
Laryngoscope Investig Otolaryngol. 2024 Mar 23;9(2):e1234. doi: 10.1002/lio2.1234. eCollection 2024 Apr.
Salivary duct carcinoma (SDC) is a rare and aggressive salivary gland malignancy. Herein, we present the largest single-institution review of SDC to date.
This is a retrospective cohort study of all histologically confirmed cases of SDC seen at our institution from January 1, 2002, to August 1, 2022. Patient demographics, treatment, histological characteristics, tumor staging, and outcomes were extracted from the electronic medical record. Kaplan-Meier and Cox regression survival analyses were performed.
This study included 119 patients with a mean age of 66.2 years. Most primary tumors arose from the parotid gland (72.3%), and 23.5% were noted to be carcinoma ex-pleomorphic adenoma. 57.1% of patients presented with regional lymph node metastasis, whereas 23.5% presented with distant disease. Kaplan-Meier analysis demonstrated a 62.4% 5-year overall survival (OS) and a 69.0% 5-year disease-specific survival (DSS). Univariate analyses indicated that presence of regional lymph node disease (<.001), distant metastasis (<.001), perineural invasion ( = .027), and lymphovascular invasion ( = .018) were predictive of decreased OS and DSS. Trastuzumab administration was not associated with survival in HER-2-positive patients receiving chemotherapy. Multivariate analyses demonstrated that presence of nodal disease (HR 30.337, 95% CI 2.782-330.851, = .005) and carcinoma ex pleomorphic adenoma (HR 5.54, 95% CI 1.024-29.933, = .047) were associated with decreased OS.
Our patients had more favorable survival rates compared to prior studies, which may be due to lower incidence of nodal disease. Factors associated with worse survival included nodal and distant metastases, perineural invasion, lymphovascular invasion, and tumor size.
Level 3.
涎腺导管癌（SDC）是一种罕见且侵袭性强的涎腺恶性肿瘤。在此，我们呈现了迄今为止最大规模的单机构SDC回顾性研究。
这是一项回顾性队列研究，纳入了2002年1月1日至2022年8月1日在本机构经组织学确诊的所有SDC病例。从电子病历中提取患者人口统计学信息、治疗情况、组织学特征、肿瘤分期及预后。进行了Kaplan-Meier生存分析和Cox回归生存分析。
本研究纳入了119例患者，平均年龄66.2岁。大多数原发性肿瘤起源于腮腺（72.3%），23.5%为多形性腺瘤恶变。57.1%的患者出现区域淋巴结转移，23.5%的患者出现远处转移。Kaplan-Meier分析显示5年总生存率（OS）为62.4%，5年疾病特异性生存率（DSS）为69.0%。单因素分析表明，区域淋巴结疾病（<.001）、远处转移（<.001）、神经周围侵犯（=.027）和脉管侵犯（=.018）可预测OS和DSS降低。在接受化疗的HER-2阳性患者中，使用曲妥珠单抗与生存无关。多因素分析表明，淋巴结疾病（HR 30.337，95%CI 2.782 - 330.851，=.005）和多形性腺瘤恶变（HR 5.54，95%CI 1.024 - 29.933，=.047）与OS降低相关。
与先前研究相比，我们的患者生存率更优，这可能归因于淋巴结疾病发生率较低。与较差生存相关的因素包括淋巴结和远处转移、神经周围侵犯、脉管侵犯及肿瘤大小。
3级。
