A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands
A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands
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DOI：
10.1002/ijc.31353
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发表时间：
2018-08-15
影响因子：
6.4
通讯作者：
van Herpen, Carla M. L.
中科院分区：
文献类型：
--
作者：
Boon, Eline;Bel, Miranda;van Herpen, Carla M. L.
涎腺导管癌(SDC)是涎腺癌的一种亚型，预后差，需要更好的预后和新的治疗方法。这项国家队列研究的目的是调查临床结果、预后因素、雄激素受体(AR)和人表皮生长因子受体2(HER2)的表达。1990年至2014年期间确诊的SDC患者由荷兰组织和细胞病理学全国网络和登记处(PALGA)确认。随后，对医疗记录进行评估，并对病理诊断进行审查。分析总生存期(OS)、无瘤生存期(DFS)、无远处转移生存期(DMFS)和预后因素。免疫组织化学(IHC)检测AR，免疫组织化学和荧光原位杂交检测HER2。共有177名患者纳入研究。中位年龄为65岁，其中75%为男性。确诊时，68%的患者有淋巴结转移，6%的患者有远处转移。中位OS为51个月，DFS为23个月，DMFS为26个月。在无远处转移的患者中，在多变量分析中，阳性淋巴结的绝对数量与较差的OS和DMF相关。AR和HER2阳性表达分别为161/168(96%)和44/153(29%)，不能作为预后因素。SDC的预后很差，大多数患者都有原发淋巴结受累。淋巴结转移的绝对数是DMFS和OS的唯一预后因素。AR的表达和--在较小程度上--HER2的表达有望在转移性和最终辅助性环境中进行系统治疗。
Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in-situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and- to a lesser extent-HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting.