Kim Jeong Heon, Woo Jeong Ho, Kwon Minsu, Jung Young Ho, Choi Seung-Ho, Lee Yoon Se
Department of Otolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sci Prog. 2025 Jul-Sep;108(3):368504251356179. doi: 10.1177/00368504251356179. Epub 2025 Jul 1.
ObjectiveRecent advancements in high-resolution ultrasonography (US) have established it as a critical tool for evaluating parotid lesions. However, the lack of standardized diagnostic criteria limits the utility of US in determining malignancy. This study investigates the potential role of US as a prognostic factor in parotid cancer.MethodsPatients diagnosed with and surgically treated for parotid cancer at our tertiary referral center from January 2016 to December 2022 were included in this retrospective cohort study. We retrospectively obtained patient data including US images and clinical factors and analyzed their correlation with various adverse features and oncological outcomes, including five-year disease-free survival (5Y DFS) and overall survival (5Y OS).ResultsA total of 126 patients were included. The 5Y DFS and 5Y OS were 81.7% ± 3.7% and 81.2% ± 4.1% respectively. Multivariate analysis revealed that age (DFS; HR 2.75 [1.76-4.29], = .023, OS; HR 3.38 [2.06-5.54], = .014), clinical nodal stage (DFS; HR 5.87 [3.74-9.21], < .001, OS; HR 9.34 [5.48-15.91], < .001) and the presence of posterior enhancement artifact on US (DFS; HR 0.33 [0.21-0.53], = .019, OS; HR 0.34 [0.20-0.57], = .037) were significant variables. In patients with early-stage parotid cancer who showed posterior enhancement, the extent of surgery did not affect treatment outcomes.ConclusionPosterior acoustic enhancement on ultrasonography is a favorable prognostic factor in parotid cancer. For patients with early-stage cancer who demonstrate posterior enhancement, minimizing the extent of surgery does not compromise oncologic outcomes.
目的
高分辨率超声检查（US）的最新进展已使其成为评估腮腺病变的关键工具。然而，缺乏标准化的诊断标准限制了超声在确定恶性肿瘤方面的效用。本研究调查超声作为腮腺癌预后因素的潜在作用。
方法
本回顾性队列研究纳入了2016年1月至2022年12月在我们的三级转诊中心被诊断为腮腺癌并接受手术治疗的患者。我们回顾性获取了患者数据，包括超声图像和临床因素，并分析了它们与各种不良特征和肿瘤学结局的相关性，包括五年无病生存率（5Y DFS）和总生存率（5Y OS）。
结果
共纳入126例患者。5Y DFS和5Y OS分别为81.7%±3.7%和81.2%±4.1%。多因素分析显示，年龄（DFS；HR 2.75 [1.76 - 4.29]，P = 0.023，OS；HR 3.38 [2.06 - 5.54]，P = 0.014）、临床淋巴结分期（DFS；HR 5.87 [3.74 - 9.21]，P < 0.001，OS；HR 9.34 [5.48 - 15.91]，P < 0.001）以及超声上出现后方增强伪像（DFS；HR 0.33 [0.21 - 0.53]，P = 0.019，OS；HR 0.34 [0.20 - 0.57]，P = 0.037）是显著变量。在表现出后方增强的早期腮腺癌患者中，手术范围不影响治疗结局。
结论
超声上的后方声学增强是腮腺癌的一个有利预后因素。对于表现出后方增强的早期癌症患者，尽量减少手术范围不会影响肿瘤学结局。
