Survival outcomes of pulmonary metastasis-directed local therapy in adenoid cystic carcinoma

IF 6.1 2区医学 Q1 ONCOLOGY

Cancer Pub Date : 2025-05-16 DOI:10.1002/cncr.35901

Camilla O. Hoff MD, Lei Feng MS, Flavia Bonini MD, Luana G. Sousa MD, Kaiwen Wang PharmD, Juliana M. Siqueira DDS, Quynh-Nhu Nguyen MD, Adel K. El-Naggar MD, PhD, Wayne L. Hofstetter MD, Boris Sepesi MD, Renata Ferrarotto MD

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引用次数: 0

Abstract

Background

Adenoid cystic carcinoma (ACC) frequently has pulmonary metastasis (PM). Given limited systemic therapy options, these metastases are often treated with pulmonary metastasis–directed local therapy (PM-LT), although with unknown impact on overall survival (OS). This single institution, retrospective cohort study investigated the survival outcomes of PM-LT versus no PM-LT in ACC.

Methods

ACC patients with at least one PM (≥5 mm) were included. PM-LT was metastasectomy or radiotherapy. Clinicopathologic characteristics were compared between patients with and without PM-LT. Primary end point was OS from PM diagnosis, with landmark analysis at 6 months, 1 year, 2 years, and 3 years after metastasis diagnosis, with Cox proportional hazards model multivariate analysis and propensity score matching analysis. Subgroup analysis by ACC histology (solid/nonsolid) was performed.

Results

Of 219 included ACC, 119 (54%) had no PM-LT and 100 (46%) did. PM-LT patients had more nonsolid histology (p = .0008), oligometastases (p < .0001), exclusively PM (p = .02), and longer time to metastasis from diagnosis (p < .0001). On univariate analysis, PM-LT by 6 months, 1 year, and 2 years, but not by 3 years, increased OS. On multivariate analysis, PM-LT by 6 months (p = .12), 1 year (p = .08), or 3 years (p = .08) did not significantly increase OS, but PM-LT by 2-years had a borderline statistically significant association (p = .045). Of the 104 nonsolid ACC, 50 underwent PM-LT and 54 did not. On univariate and multivariate analysis, PM-LT did not increase OS at any time point for nonsolid ACC.

Conclusion

This is the largest study of survival outcomes of PM-LT in metastatic ACC. Findings suggest PM-LT does not increase OS in unselected ACC.

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肺转移导向的腺样囊性癌局部治疗的生存结果

背景腺样囊性癌（ACC）常伴有肺转移。鉴于有限的全身治疗选择，这些转移瘤通常采用肺转移定向局部治疗（PM-LT）治疗，尽管对总生存期（OS）的影响尚不清楚。这项单机构、回顾性队列研究调查了ACC中PM-LT与无PM-LT的生存结果。方法纳入至少一个PM（≥5 mm）的ACC患者。PM-LT为转移性切除或放疗。比较PM-LT患者与非PM-LT患者的临床病理特征。主要终点为PM诊断后的OS，在转移诊断后6个月、1年、2年和3年进行里程碑分析，采用Cox比例风险模型多因素分析和倾向评分匹配分析。按ACC组织学（固体/非固体）进行亚组分析。结果219例ACC患者中，无PM-LT 119例（54%），有PM-LT 100例（46%）。PM-LT患者有更多的非实体组织学（p = 0.0008）、低转移灶(p <；.0001)，完全的PM (p = .02)，从诊断到转移的时间更长(p <；。)。在单变量分析中，PM-LT延长6个月、1年和2年，但不延长3年，OS增加。多因素分析显示，PM-LT治疗6个月（p = .12）、1年（p = .08）和3年（p = .08）均未显著增加OS，但PM-LT治疗2年有统计学上的显著相关性（p = .045）。在104例非实性ACC中，50例行PM-LT， 54例未行。在单因素和多因素分析中，PM-LT在任何时间点都没有增加非固定性ACC的OS。结论：这是对转移性ACC中PM-LT生存结局的最大研究。研究结果表明PM-LT不会增加未选择ACC的OS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research