涎腺肿瘤淋巴结转移分期的相关性-来自三级肿瘤中心的回顾性分析

Aswin Nagarajan, R. Swaminathan, G. Selvaluxmy, Ramya Ravichandar
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摘要

背景:唾液腺恶性肿瘤通常没有适当的分期,并根据其高危特征进行治疗。预后不是基于肿瘤淋巴结转移(TNM)分期的常规预测。本研究的目的:本研究的目的是确定TNM分期对唾液腺恶性肿瘤的预后是否有用。材料与方法:回顾性分析我院2010-2014年治疗的涎腺恶性肿瘤患者。分析年龄、性别、位置、组织学、分期、接受的治疗和生存率。结果:共分析79例。发病时的中位年龄为45岁。男女比例为1.63:1。粘液表皮样癌(37.9%)和腺样囊性癌(31.6%)是常见的组织学类型。5年无病生存率(DFS)为73.4%,总生存率为82.3%。5年DFS在女性、粘液表皮样癌和腺样囊性癌组织学类型、T1和T4 (P = 0.027)、N0和N2 (P = 0.004)中均显著升高,年龄≥55岁的患者显著低于年龄< 35岁和35 - 44岁的患者。不同部位和治疗组的DFS无显著差异。单因素分析结果显示,随着t状态(P = 0.459)、诊断年龄(P = 0.035)、淋巴结状态(P = 0.059)和组织学类型(P = 0.02)的增加,复发风险增加。结论:涎腺恶性肿瘤的5年DFS在不同T、n状态下的区分呈上升趋势,提示治疗前TNM分期的有效性,需要进一步评估。
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Relevance of tumor node metastasis staging in salivary gland tumors – a retrospective analysis from a tertiary cancer center
Background: Salivary gland malignancies are generally not appropriately staged and are treated based on the high-risk features. Prognosis is not routinely predicted based on the tumor node metastasis (TNM) staging. Aim of this Study: The aim of the study was to identify whether TNM staging is useful in the prognosis of salivary gland malignancies. Materials and Methods: The patients of salivary gland malignancies treated during the period of years 2010–2014 were analyzed retrospectively. Age, gender, location, histology, stage, treatment received, and survival were analyzed. Results: A total of 79 cases were analyzed. The median age at presentation was 45 years. The male-to-female ratio was 1.63:1. Mucoepidermoid (37.9%) and adenoid cystic carcinoma (31.6%) were the common histological types. The 5-year disease-free survival (DFS) was 73.4% and overall survival was 82.3%. The 5-year DFS was significantly higher in women, mucoepidermoid and adenoid cystic carcinomas histology types, T1 versus T4 (P = 0.027), and N0 versus N2 (P = 0.004) and significantly lower in age ≥55 years than age < 35 and 35–44. DFS for different sites and treatment groups did not show any significant differences. The factors with significant result on univariate analysis showed an increasing risk of recurrence with increasing T-status (P = 0.459), increasing age at diagnosis (P = 0.035), nodal status (P = 0.059), and histology type (P = 0.02). Conclusion: There is an increasing trend to differentiate 5-year DFS for salivary gland malignancies between different T- and N-status suggesting usefulness of TNM staging before treatment and needs further evaluation.
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