Defining the surgical margins of adenoid cystic carcinoma and their impact on outcome: An international collaborative study
Defining the surgical margins of adenoid cystic carcinoma and their impact on outcome: An international collaborative study
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DOI：
10.1002/hed.24740
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发表时间：
2017-05-01
影响因子：
2.9
通讯作者：
Gil, Ziv
中科院分区：
文献类型：
--
作者：
Amit, Moran;Na'ara, Shorook;Gil, Ziv
背景头颈部腺样囊性癌（ACC）的主要治疗方法是切缘阴性的手术切除。本研究的目的是定义的边缘状态，与ACC的头部和颈部的生存结局。MethodsWe进行了单变量和多变量分析的国际data.ResultsData的507例ACC的头部和颈部进行了分析;负边缘定义为5毫米检测253例（50%）。在多变量分析中，阳性边缘状态对总生存期（OS）和疾病特异性生存期（DSS）的风险比（HR）分别为2.68（95%置信区间[CI]，1.2-6.2; p = 0.04）和2.63（95% CI，1.1-6.3; p = 0.03）。密切的利润率没有显着影响的结果，与HR为1.1（95%CI，0.4-3.0; p = 0.12）和1.07（95%CI，0.3-3.4; p = 0.23）OS和DSS，分别与负margins.ConclusionIn头部和颈部ACC，积极的利润率与最差的结果。阴性或接近边缘与改善的结果相关，无论距离肿瘤的距离如何。(c)2017 Wiley Periodicals，Inc.头颈部39：1008-1014，2017
BackgroundThe mainstay of treatment in adenoid cystic carcinoma (ACC) of the head and neck is surgical resection with negative margins. The purpose of this study was to define the margin status that associates with survival outcomes of ACC of the head and neck.MethodsWe conducted univariate and multivariate analyses of international data.ResultsData of 507 patients with ACC of the head and neck were analyzed; negative margins defined as 5 mm were detected in 253 patients (50%). On multivariate analysis, the hazard ratios (HRs) of positive margin status were 2.68 (95% confidence interval [CI], 1.2-6.2; p = .04) and 2.63 (95% CI, 1.1-6.3; p = .03) for overall survival (OS) and disease-specific survival (DSS), respectively. Close margins had no significant impact on outcome, with HRs of 1.1 (95% CI, 0.4-3.0; p = .12) and 1.07 (95% CI, 0.3-3.4; p = .23) for OS and DSS, respectively, relative with negative margins.ConclusionIn head and neck ACC, positive margins are associated with the worst outcome. Negative or close margins are associated with improved outcome, regardless of the distance from the tumor. (c) 2017 Wiley Periodicals, Inc. Head Neck 39: 1008-1014, 2017