Adenoid cystic carcinoma of the head and neck: A single-center analysis of 105 consecutive cases over a 30-year period
Adenoid cystic carcinoma of the head and neck: A single-center analysis of 105 consecutive cases over a 30-year period
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DOI：
10.1016/j.oraloncology.2013.05.004
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发表时间：
2013-08-01
期刊：
影响因子：
4.8
通讯作者：
Leemans, C. Rene
中科院分区：
文献类型：
--
作者：
van Weert, Stijn;Bloemena, Elisabeth;Leemans, C. Rene
背景资料：腺样囊性癌是一种罕见的涎腺恶性肿瘤，由于经常发生远处转移和晚期局部复发，无病生存率很低。以往关于结局的单中心报告大多包含小系列。在这份报告中，一个相对较大的系列105例进行了分析，所有治疗在自由大学医学中心，阿姆斯特丹，荷兰超过30年的时间，其中治疗策略保持不变。方法：所有病例ACC的头部和颈部之间的1979年和2009年在我们的机构进行了分析，通过医疗图表审查。分析复发模式和可能的预后因素（T分期、N状态、年龄、性别、唾液腺受累类型、组织学分级、手术切缘、神经浸润（PNI）和术后放疗（RT））。总生存期的5年、10年和20年生存率分别为68%、52%和28%。T分期、N状态、手术切缘、组织学亚型和年龄是生存率的高度显著预测因素。结论：T分期、N状态、手术切缘、组织学分级和年龄是影响头颈部ACC患者预后的主要因素。远处转移经常发生，主要发生在治疗后的前5年。局部复发往往发生在较晚的时期，这阻碍了对ACC治疗患者的长期随访。III级ACC由于其典型的侵袭性生物学行为和相对较差的预后，应被视为ACC组中的一个特定实体，这意味着需要改进辅助治疗。(C)2013由Elsevier Ltd.出版
Background: Adenoid cystic carcinoma is a rare salivary gland malignancy with a poor disease free survival due to frequent distant metastases and late local recurrences. Previous single-center reports on outcome mostly encompass small series. In this report a relative large series of 105 cases is analyzed, all treated at the VU University Medical Center, Amsterdam, The Netherlands over a 30-year period in which treatment strategies remained unchanged.Methods: All cases of ACC of the head and neck between 1979 and 2009 at our institution were analyzed through a medical chart review. Recurrence patterns and possible prognostic factors (T-stage, N-status, age, gender, type of salivary gland involved, histological grade, surgical margins, perineural invasion (PNI) and postoperative radiotherapy (RT)) were analyzed.Results: One-hundred and five cases of ACC of the head and neck were identified. Five-, ten-and twenty-year survival rates for overall survival were 68%, 52% and 28%, respectively. T-stage, N-status, surgical margins, histological subtype and age were highly significant predictors for survival. PNI was not a negative prognosticator.Conclusions: T-stage, N-status, surgical margins, histological grade and age are the main predictors of survival-outcome in ACC of the head and neck. Distant metastasis frequently develop, mainly in the first 5 years post treatment. Local recurrences often develop even later on, warranting long term follow up of patients treated for ACC. Grade III ACC should be considered a specific entity within the group of ACC due to its typical aggressive biological behavior and relatively poor outcome, implicating the need for an improved adjuvant treatment. (C) 2013 Published by Elsevier Ltd.