Risk factors and prognosis for salivary gland adenoid cystic carcinoma in southern china A 25-year retrospective study
Risk factors and prognosis for salivary gland adenoid cystic carcinoma in southern china A 25-year retrospective study
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DOI：
10.1097/md.0000000000005964
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发表时间：
2017-02-01
期刊：
影响因子：
1.6
通讯作者：
Liao, Gui-qing
中科院分区：
文献类型：
--
作者：
Ouyang, Dai-qiao;Liang, Li-zhong;Liao, Gui-qing
腺样囊性癌(ACC)生长缓慢，局部复发频繁，远处转移(DM)发生率高。这项研究的目的是评估预测局部区域(LR)复发、DM和ACC患者生存的因素。对1990-2015年间涎腺ACC患者的医疗记录进行了回顾。临床参数被评估以确定与LR复发、DM和这些患者的生存的相关性。在228名接受手术作为最终治疗的患者中，210名(92.1%)在研究中得到了随访。(30.5%)患者发现DM，58例(27.6%)LR复发。5年、10年和15年总生存率估计分别为84.7%、70.8%和34.0%。多因素分析显示，淋巴血管侵犯和高T分级是非常强烈的不良因素，它们独立地影响LR复发、DM和ACC患者的生存。阳性/接近切缘和N-1状态分别是DM和LR复发的独立危险因素。ACC患者的生存也受肿瘤部位的影响。淋巴血管侵犯和高T分级是ACC患者预后的非常强烈的不利因素和独立预测因素，影响LR控制、DM控制和生存。
Adenoid cystic carcinoma (ACC) is characterized by slow growth, frequent local recurrences, and high incidence of distant metastasis (DM). The aim of this study was to evaluate predictive factors for local-regional (LR) recurrence, DM, and survival in ACC.A retrospective review of the medical records for patients with salivary glands ACC from 1990 to 2015 was performed. The clinical parameters were assessed to identify correlations with the development of LR recurrence, DM, and survival of these patients.Among 228 patients who underwent surgery as definitive treatment, 210 (92.1%) were followed up in the study. DM was detected in 64 (30.5%) patients, LR recurrence was detected in 58 (27.6%) patients. The estimated 5, 10, and 15-year overall survival rates were 84.7%, 70.8%, and 34.0%, respectively. Multivariate analysis revealed that the presence of lymphovascular invasion and a high T classification were very strong adverse factors, which independently influenced LR recurrence, DM, and survival of ACC patients. Positive/close margin and N-1 status were independent risk factors for DM and LR recurrence, respectively. Survival of ACC patents was also affected by tumor location.Presence of lymphovascular invasion and a high T classification were very strong adverse factors and independent predictors for ACC patients' prognosis, which influenced LR control, DM control, and survival.