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儿童和青少年腮腺肿瘤的长期随访及预后分析

Long-term follow-up and prognostic analysis of parotid tumors in children and adolescents.

作者信息

Liu Lei, Xiang Yuqing, Shui Chunyan, Li Chao, Xiong Lujing, Hu Jinchuan, Ai Hao, Zhou Yuqiu, Jiang Jian, Cai Yongcong

机构信息

Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China Chengdu China.

School of Medicine University of Electronic Science and Technology of China Chengdu China.

出版信息

Laryngoscope Investig Otolaryngol. 2024 Jun 4;9(3):e1275. doi: 10.1002/lio2.1275. eCollection 2024 Jun.


DOI:10.1002/lio2.1275
PMID:38835331
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11149764/
Abstract

OBJECTIVES: The objective of this study is to summarize the clinical characteristics, treatment, and prognosis of parotid tumors in children and adolescents. METHODS: Fifty-three children and adolescents diagnosed with parotid gland tumors were included. Survival was evaluated using the Kaplan-Meier method. Log-rank test and multivariate analysis were used to analyze the association between clinical factors and recurrence. RESULTS: Of the 53 patients, 30 cases were benign and 23 cases were malignant. All patients underwent surgery. Patients with malignant tumors with high-risk factors received radiotherapy or chemotherapy. The median follow-up time was 61 months. Of these, 1 patient with benign tumor and 5 patients with malignant tumors recurred. Of the patients with malignant tumors, 2 developed distant metastases and 2 died. The 5-year overall survival (OS) and 5-year locoregional recurrence-free survival (LRFS) rates for benign tumors were 100.0% and 92.9%, respectively, whereas the 5-year OS and 5-year LRFS rates for malignant tumors were 94.4% and 72.5%, respectively. The log-rank univariate test showed that tumor size >3.5 cm ( = .056), distant metastasis ( = .056), and stage III and IV ( = .032) were associated with recurrence. However, multivariate analysis did not show the above factors to be independent prognostic factors for LRFS. CONCLUSION: Surgery for benign tumors depends on the location and size. Surgery for malignant parotid tumors depends mainly on the stage, grade, pathological type, and recurrence. Prophylactic lymph node dissection is required for high-grade tumors. Radiotherapy or chemotherapy for children needs more research. Both benign and malignant tumors have high survival rates after active treatment. LEVEL OF EVIDENCE: Level 2.

摘要

目的:本研究的目的是总结儿童和青少年腮腺肿瘤的临床特征、治疗方法及预后情况。 方法:纳入53例诊断为腮腺肿瘤的儿童和青少年。采用Kaplan-Meier法评估生存率。采用对数秩检验和多因素分析来分析临床因素与复发之间的关联。 结果:53例患者中,30例为良性,23例为恶性。所有患者均接受了手术治疗。具有高危因素的恶性肿瘤患者接受了放疗或化疗。中位随访时间为61个月。其中,1例良性肿瘤患者和5例恶性肿瘤患者复发。恶性肿瘤患者中,2例发生远处转移,2例死亡。良性肿瘤的5年总生存率(OS)和5年局部区域无复发生存率(LRFS)分别为100.0%和92.9%,而恶性肿瘤的5年OS和5年LRFS分别为94.4%和72.5%。对数秩单因素检验显示,肿瘤大小>3.5 cm(P = 0.056)、远处转移(P = 0.056)以及Ⅲ期和Ⅳ期(P = 0.032)与复发相关。然而,多因素分析未显示上述因素是LRFS的独立预后因素。 结论:良性肿瘤的手术取决于肿瘤的位置和大小。腮腺恶性肿瘤的手术主要取决于分期、分级、病理类型和复发情况。高级别肿瘤需要进行预防性淋巴结清扫。儿童放疗或化疗需要更多研究。积极治疗后,良性和恶性肿瘤的生存率均较高。 证据水平:2级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/c2c505792ff3/LIO2-9-e1275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/519825172686/LIO2-9-e1275-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/fefb9920c88c/LIO2-9-e1275-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/c2c505792ff3/LIO2-9-e1275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/519825172686/LIO2-9-e1275-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/fefb9920c88c/LIO2-9-e1275-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/11149764/c2c505792ff3/LIO2-9-e1275-g001.jpg

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引用本文的文献

[1]
High-frequency shear wave MR elastography of parotid glands: custom driver design and preliminary results.

Sci Rep. 2024-10-18

本文引用的文献

[1]
Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study-a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma.

Eur Arch Otorhinolaryngol. 2023-7

[2]
Primary and Secondary Tumors of the Parotid Gland: Clinical Features and Prognosis.

Cancers (Basel). 2023-2-17

[3]
Systemic therapy for salivary gland malignancy: current status and future perspectives.

Jpn J Clin Oncol. 2022-4-6

[4]
Mucoepidermoid carcinoma of the parotid gland: Twenty-year experience in treatment and outcomes.

Head Neck. 2021-9

[5]
Epidemiology of Primary Epithelial Salivary Gland Tumors in Southern Poland-A 26-Year, Clinicopathologic, Retrospective Analysis.

J Clin Med. 2021-4-13

[6]
Prognostic scoring models in parotid gland carcinoma.

Head Neck. 2021-7

[7]
Different Surgical Strategies in the Prevention of Frey Syndrome: A Systematic Review and Meta-analysis.

Laryngoscope. 2021-8

[8]
Salivary gland tumours in Iceland 1986-2015: a nationwide epidemiological analysis over a 30-year time period.

APMIS. 2021-2

[9]
Oncological outcomes of preoperatively unexpected malignant tumors of the parotid gland.

Eur Arch Otorhinolaryngol. 2021-6

[10]
Challenges with preoperative diagnosis of low/intermediate-grade carcinoma of the parotid gland: single-center study of 112 patients.

Eur Arch Otorhinolaryngol. 2020-7

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