Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic College of Medicine, Cleveland, Ohio, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.
Laryngoscope. 2024 Dec;134(12):4935-4946. doi: 10.1002/lary.31588. Epub 2024 Jun 19.
Changing location of postoperative radiotherapy (PORT) after treatment at a high-volume facility (HVF) is associated with worse survival in various head and neck cancers. Our study investigates this relationship in salivary gland cancer (SGC).
The 2004-2016 National Cancer Database was queried for all cases of adult SGC treated with surgery and PORT with or without adjuvant chemotherapy. Patients with multiple cancer diagnoses, metastatic disease, or unknown PORT facility were excluded. Reporting facilities with >95th percentile annual case volume were classified as HVFs, the remainder were classified low-volume facilities (LVFs).
A total of 7885 patients met inclusion criteria, of which 418 (5.3%) were treated at an HVF. Patients treated at an HVF had higher rates clinical nodal positivity (18.2% vs. 14.0%, p < 0.001) and clinical T3/T4 (27.3% vs. 20.7%, p = 0.001) disease. Patients at HVFs changed facility for PORT at lower rates (18.9% vs. 24.5%, p = 0.009). Patients treated at an HVF had higher 5-year overall survival (5-OS) than those treated at an LVF (79.0% vs. 72.0%, p = 0.042). Patients treated at an HVF that changed PORT facility had worse 5-OS (60.8% vs. 83.2%, p < 0.001). Radiation facility change was an independent predictor of worse survival in patients treated at an HVF (HR: 8.99 [3.15-25.67], p < 0.001) but not for patients treated at a LVF (HR: 1.11 [0.98-1.25], p = 0.109).
Patients treated at an HVF changing facility for PORT for SGC experience worse survival. Our data suggest patients treated surgically at an HVF should be counseled to continue their PORT at the same institution.
3 Laryngoscope, 134:4935-4946, 2024.
在高容量治疗机构（HVF）治疗后改变术后放疗（PORT）的位置与各种头颈部癌症的生存率降低有关。我们的研究调查了这一发现在唾液腺癌（SGC）中的关系。
2004 年至 2016 年，国家癌症数据库对接受手术和 PORT 治疗的成人 SGC 患者进行了所有病例的查询，这些患者接受了手术和 PORT 治疗，无论是否接受了辅助化疗。排除有多种癌症诊断、转移性疾病或 PORT 设施不明的患者。报告设施的年病例量超过第 95 个百分位被归类为 HVF，其余的被归类为低容量设施（LVF）。
共有 7885 名患者符合纳入标准，其中 418 名（5.3%）在 HVF 治疗。在 HVF 治疗的患者有更高的临床淋巴结阳性率（18.2%比 14.0%，p<0.001）和临床 T3/T4 疾病率（27.3%比 20.7%，p=0.001）。在 HVF 治疗的患者改变 PORT 设施的比例较低（18.9%比 24.5%，p=0.009）。在 HVF 治疗的患者 5 年总生存率（5-OS）高于在 LVF 治疗的患者（79.0%比 72.0%，p=0.042）。在 HVF 治疗的患者改变 PORT 设施的患者 5 年总生存率更差（60.8%比 83.2%，p<0.001）。在 HVF 治疗的患者中，改变放疗设施是生存不良的独立预测因素（HR：8.99[3.15-25.67]，p<0.001），但对于在 LVF 治疗的患者则不是（HR：1.11[0.98-1.25]，p=0.109）。
在 HVF 治疗的 SGC 患者改变 PORT 设施的患者的生存率更差。我们的数据表明，在 HVF 接受手术治疗的患者应被建议继续在同一机构接受 PORT 治疗。
3 级喉镜，134：4935-4946，2024。
