Punita L, Naik Nagendra, Prasad Pallavi, Kesari Amit, Shankar Ravi, Kumar Anoop, Kapoor Vishwas, Kumar Shaleen, Rastogi Neeraj, Agrawal Sushma, Mishra Shagun
Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India.
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India.
Indian J Otolaryngol Head Neck Surg. 2024 Jun;76(3):2660-2674. doi: 10.1007/s12070-023-04348-2. Epub 2024 Mar 25.
Salivary gland tumors are relatively rare and can exhibit various clinical behaviors. The study aims to understand the natural history, pathology, diagnostic workup, and treatment strategies for these tumors to improve patient outcomes. The audit included patients with salivary gland tumors detected through radiology or cytology. Patients underwent surgery, with some receiving adjuvant treatment. Demographic information, treatment interventions, and survival outcomes were analyzed using SPSS software. A total 89 as malignant salivart gland tumours were audited Malignant tumors were predominantly found in the parotid gland, with fewer cases in the minor salivary gland and submandibular gland.The median age of presentation was 47 years, and the majority of patients were male. The study examined various pathological and clinical factors, including tumor stage, nodal status, and the presence of facial palsy. Surgical procedures and histological types of tumors were documented. Adverse histological features like positive margins, lymph node positivity, lympho-vascular invasion, extracapsular spread, and perineural invasion were noted. POSTOP RT was administered to high-risk patients. Most malignant salivary gland tumors were found in the parotid gland, while minor salivary gland tumors were underrepresented in the audit. Surgical practices were diverse. Radiotherapy protocols were relatively standardized. The study found that certain histological features, such as lymph node positivity, margin positivity, lympho-vascular invasion, perineural invasion, and extracapsular spread, were associated with adverse effects on DFS and OS. The findings suggest that specific histological features, including LVI and ECE have emerged as independent prognostic factors for DFS and OS.
涎腺肿瘤相对罕见,可表现出多种临床行为。该研究旨在了解这些肿瘤的自然病史、病理学、诊断检查及治疗策略,以改善患者预后。此次审核纳入了通过放射学或细胞学检查发现的涎腺肿瘤患者。患者接受了手术治疗,部分患者还接受了辅助治疗。使用SPSS软件对人口统计学信息、治疗干预措施及生存结果进行了分析。共审核了89例恶性涎腺肿瘤。恶性肿瘤主要发生在腮腺,小涎腺和下颌下腺的病例较少。发病的中位年龄为47岁,大多数患者为男性。该研究考察了多种病理和临床因素,包括肿瘤分期、淋巴结状态及面神经麻痹情况。记录了手术程序和肿瘤的组织学类型。注意到了如切缘阳性、淋巴结阳性、淋巴管侵犯、包膜外扩散及神经周围侵犯等不良组织学特征。对高危患者实施了术后放疗。大多数恶性涎腺肿瘤发生在腮腺,而小涎腺肿瘤在此次审核中的占比不足。手术方式多样。放疗方案相对标准化。研究发现,某些组织学特征,如淋巴结阳性、切缘阳性、淋巴管侵犯、神经周围侵犯及包膜外扩散,与无病生存期(DFS)和总生存期(OS)的不良影响相关。研究结果表明,包括淋巴管侵犯(LVI)和包膜外侵犯(ECE)在内的特定组织学特征已成为DFS和OS的独立预后因素。