Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province CN, Hangzhou, People's Republic of China.
Sci Rep. 2024 Apr 20;14(1):9086. doi: 10.1038/s41598-024-59757-2.
The survival significance of the number of positive lymph nodes in salivary gland carcinoma remains unclear. Thus, the current study aimed to determine the effect of the number of positive lymph nodes on disease-specific survival (DSS) and overall survival (OS) in cN0 mucoepidermoid carcinoma (MEC) of the major salivary gland. Patients surgically treated for MEC of the major salivary gland between 1975 and 2019 were retrospectively enrolled from the surveillance, epidemiology, and end results database. The total population was randomly divided into training and test groups (1:1). Primary outcome variables were DSS and OS. Prognostic models were constructed based on the independent prognostic factors determined using univariate and multivariate Cox analyses in the training group and were validated in the test group using C-index. A total of 3317 patients (1624 men and 1693 women) with a mean age of 55 ± 20 years were included. The number of positive lymph nodes was an independent prognostic factor for both DSS and OS, but the effect began when at least two positive lymph nodes for DSS and three positive lymph nodes for OS were found. Predictive models for DSS and OS in the training group had C-indexes of 0.873 (95% confidence interval [CI] 0.853-0.893) and 0.835 (95% CI 0.817-0.853), respectively. The validation of the test group showed C-indexes of 0.877 (95% CI 0.851-0.902) for DSS and 0.820 (95% CI 0.798-0.842) for OS. The number of positive lymph nodes was statistically associated with survival in cN0 major salivary gland MEC. The current prognostic model could provide individualized follow-up strategies for patients with high reliability.
淋巴结阳性数量对涎腺癌生存意义仍不明确。因此，本研究旨在确定涎腺黏液表皮样癌（MEC）cN0 患者淋巴结阳性数量对疾病特异性生存（DSS）和总生存（OS）的影响。从监测、流行病学和最终结果数据库中回顾性纳入 1975 年至 2019 年间接受手术治疗的涎腺大 MEC 患者。将总人群随机分为训练组和测试组（1:1）。主要观察终点为 DSS 和 OS。在训练组中，基于单因素和多因素 Cox 分析确定的独立预后因素构建预后模型，并在测试组中使用 C 指数进行验证。共纳入 3317 例（男 1624 例，女 1693 例）患者，平均年龄 55±20 岁。淋巴结阳性数量是 DSS 和 OS 的独立预后因素，但至少有 2 个阳性淋巴结对 DSS 有影响，3 个阳性淋巴结对 OS 有影响。训练组中 DSS 和 OS 的预测模型的 C 指数分别为 0.873（95%可信区间 [CI]：0.853-0.893）和 0.835（95%CI：0.817-0.853）。测试组验证结果显示，DSS 的 C 指数为 0.877（95%CI：0.851-0.902），OS 的 C 指数为 0.820（95%CI：0.798-0.842）。淋巴结阳性数量与 cN0 涎腺 MEC 患者的生存情况具有统计学关联。目前的预后模型可为患者提供高可靠性的个体化随访策略。
