Lung metastasis resection of adenoid cystic carcinoma of salivary glands
Lung metastasis resection of adenoid cystic carcinoma of salivary glands
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DOI：
10.1016/j.ejcts.2007.12.057
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发表时间：
2008-05-01
影响因子：
3.4
通讯作者：
Rusca, Michele
中科院分区：
文献类型：
--
作者：
Bobbio, Antonio;Copelli, Chiara;Rusca, Michele
背景：腺样囊性癌是一种罕见的起源于外分泌粘液腺的肿瘤，以其易发生远处转移而著称。探讨涎腺腺样囊性癌肺转移切除的价值。方法：对1982-2006年间接受手术治疗的涎腺腺样囊性癌患者进行回顾性研究。排除了原发瘤大体不完全切除或在随访中丢失的患者。在50名符合条件的患者数据库中，27名患者在随访期间被确认为肿瘤复发；20名患者首次被诊断为远处转移，7名患者被诊断为局部转移。复发。9例出现孤立性肺复发的患者接受了完全肺转移切除术。回顾了人口学数据、病理特征、手术和术后记录，以及最新的生存情况。结果：在研究期间，26名男性和24名女性接受了腺样囊性癌根治性手术，平均年龄57岁(范围33-79岁)。在20例患者中，在中位自由间隔时间为3年(范围1-12)的情况下，观察到远处转移复发。9例患者中位自由间隔时间为5年(范围1-12)，其中5例为单肺转移灶切除，1例为多发单肺转移灶切除，3例为多发双侧肺转移灶切除。在这些患者中，有6名患者发现了新的疾病复发：4名患者接受了进一步的肺转移切除术，但全部患者。观察其中的疾病进展情况。总体平均生存时间为16年(SE=1.4)，5年、10年和15年的精算存活率分别为77%、66%和56%。出现远处转移的患者的平均生存期为11年(SE=2.2)。发生远处转移的9例患者术后平均生存期为72个月(SE=15.8)，11例未行转移切除的患者平均生存期为62个月(SE=15.1)。结论：腺样囊性癌患者易发生肺内复发。然而，完全切除肺转移瘤对病程的影响还有待确定。(C)2008年欧洲胸心外科协会。爱思唯尔出版，版权所有。
Background: Adenoid cystic carcinoma is a rare tumour originating from the exocrine mucous glands, known for its high propensity for distant metastases. The value of lung metastasis resection from adenoid cystic carcinoma of salivary glands origin is evaluated. Methods: A retrospective study was conducted on patients undergoing surgery for primary adenoid cystic carcinoma of the salivary glands between 1982 and 2006. Patients were excluded who had primary tumour macroscopic incomplete resection or were lost at follow-up. From a database of 50 eligible patients, 27 were identified as having presented a tumour recurrence during follow-up; in 20 it was first diagnosed in the form of distant metastases, and in 7 in the form of loco-regional. recurrence. Nine patients who presented isolated lung recurrence underwent complete lung metastasectomy. Demographic data, pathologic characteristics and operative and postoperative record were reviewed, as well as updated survival. Results: Twenty-six men and 24 women with a median age of 57 years (range 33-79) underwent radical surgery for adenoid cystic carcinoma during the study period. In 20 patients, at a median free interval time of 3 years (range 1-12), a distant metastasis relapse was observed. Nine patients with a median free interval time of 5 years (range 1-12) underwent lung metastasectomy: five had single metastasis resection, one multiple mono-pulmonary and three multiple and bilateral. In six of these patients a new disease recurrence was noted: four patients underwent further lung metastasectomy, but in all. of them progression of the disease was observed. Mean survival of the population as a whole resulted as being 16 years (SE = 1.4) with an actuarial survival of 77% at 5 years, 66% at 10 years and 56% at 15 years. Mean survival of patients having presented with distant metastases resulted as being 11 years (SE = 2.2). Mean survival after appearance of distant metastases resulted as being 72 months (SE = 15.8) in the 9 patients treated by metastasectomy, and 62 months (SE = 15.1) in the 11 who did not have metastasis resection. Conclusions: Patients with adenoid cystic carcinoma could be frequently encountered with disease recurrence confined to the lung. The impact of complete lung metastasis resection on the course of the disease, however, is yet to be determined. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.