The management of salivary neoplasms: an overview.
The management of salivary neoplasms: an overview.
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DOI：
10.1016/s0385-8146(85)80044-4
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
R. Spiro
中科院分区：
文献类型：
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作者：
R. Spiro
从1939年到1973年，2807名患有唾液腺肿瘤的患者在纪念斯隆凯特琳癌症中心接受了最终治疗。其中包括1965例腮腺病变患者（70%），244例颌下腺肿瘤患者（8%），607例（22%）肿瘤主要发生在上气消化道的粘液分泌腺（少量唾液）。腮腺、下颌骨和小唾液腺的恶性肿瘤比例分别为25,43和82%；良性肿瘤多见于女性。根据组织学分级对粘液表皮样癌、腺泡细胞癌和大多数腺癌进行细分，并根据美国癌症分期联合委员会制定的标准对所有患者进行回顾性分期。治疗几乎完全是手术，手术的范围取决于肿瘤的范围，而不是其组织学。在恶性腮腺肿瘤患者中，面神经只有附着于肿瘤或直接受累于肿瘤时才行切除。淋巴结切除术通常用于可触及转移的患者。为了了解一些唾液肿瘤的缓慢生长，延长随访（本研究中至少10年）是必要的。结果取决于肿瘤的起源、临床分期和组织学表现之间复杂的相互作用。这项研究早于我们目前对术后放射治疗的兴趣，但其他报告表明联合治疗可以增强局部控制。
From 1939 through 1973, 2,807 patients with salivary gland tumors received definitive treatment at the Memorial Sloan Kettering Cancer Center. This included 1,965 patients (70%) with parotid gland lesions, 244 patients (8%) with neoplasms in the submandibular gland, and 607 patients (22%) with tumors which arose in the predominantly mucus secreting glands (minor salivary) which line the upper aerodigestive tract. The proportion with malignant tumors was 25, 43, and 82% in the parotid, submandibular and minor salivary glands, respectively; benign tumors occurred more often in women. Mucoepidermoid, acinic cell and most adenocarcinomas were subdivided according to histologic grade and all patients were retrospectively staged according to criteria established by the American Joint Committee on Cancer Staging. Treatment was almost exclusively surgical and the extent of the operation performed depended on the extent of the tumor rather than its histology. In patients with malignant parotid tumors, the facial nerve was sacrificed only if it was adherent to or directly involved by the tumor. Lymphadenectomy was usually reserved for those patients who had palpable metastases. Prolonged follow-up (10 years minimum in this study) is necessary in order to appreciate the slow growth of some salivary neoplasms. Results depended upon the complex interplay between the site of origin, the clinical stage, and the histologic appearance of the tumors. This study antedates our current interest in postoperative radiation therapy, but other reports suggest that combination therapy enhances local control.