Ohkoshi Akira, Ishii Ryo, Higashi Kenjiro, Shishido Tadahisa, Kano Satoshi, Kusaka Takahiro, Matsushita Daisuke, Murayama Kosuke, Miyakura Yuya, Kubota Satoshi, Sato Ryosuke, Godo Shino, Tomizawa Hiroki, Toyoma Satoshi, Tagawa Ai, Shirotori Akina, Katori Yukio
Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Oral Oncol. 2025 Jan;160:107131. doi: 10.1016/j.oraloncology.2024.107131. Epub 2024 Dec 2.
Salivary gland cancer is a rare disease composed of more than 20 histological types with different grades of malignancy. The aim of this multicenter, retrospective study was to identify the most important predictors affecting recurrence and survival after surgery.
A total of 543 patients with salivary gland cancers that underwent curative surgery between 2012 and 2022 in 13 institutions in northern Japan were evaluated in this study. Predictors affecting recurrence and survival were identified by univariate and multivariate Cox regression analyses. Age, sex, primary site, histological type, pathological T status, surgical margin, lymph node metastasis, extranodal extension, and postoperative radiotherapy were the variables evaluated.
Multivariate Cox regression analysis showed that increasing age, submandibular cancer, pathological T status 3 or 4, positive surgical margin, and lymph node metastasis, especially with extranodal extension, were independent risk factors for both recurrence and survival. Sublingual cancer was an independent risk factor for recurrence. Postoperative radiotherapy was associated with a lower risk of recurrence and a good prognosis, and adenoid cystic carcinoma was associated with a good prognosis.
Lymph node metastasis with extranodal extension was the most important prognostic factor affecting both recurrence and survival after surgery, adenoid cystic carcinoma was associated with a good prognosis, and postoperative radiotherapy was associated with a lower risk of recurrence and a good prognosis.
唾液腺癌是一种罕见疾病，由20多种组织学类型组成，恶性程度各不相同。这项多中心回顾性研究的目的是确定影响手术后复发和生存的最重要预测因素。
本研究评估了2012年至2022年期间在日本北部13家机构接受根治性手术的543例唾液腺癌患者。通过单因素和多因素Cox回归分析确定影响复发和生存的预测因素。评估的变量包括年龄、性别、原发部位、组织学类型、病理T分期、手术切缘、淋巴结转移、结外扩展和术后放疗。
多因素Cox回归分析显示，年龄增加、下颌下癌、病理T分期为3或4、手术切缘阳性以及淋巴结转移，尤其是伴有结外扩展，是复发和生存的独立危险因素。舌下癌是复发的独立危险因素。术后放疗与较低的复发风险和良好的预后相关，腺样囊性癌与良好的预后相关。
伴有结外扩展的淋巴结转移是影响手术后复发和生存的最重要预后因素，腺样囊性癌与良好的预后相关，术后放疗与较低的复发风险和良好的预后相关。
