中低级别唾液腺癌治疗的实践模式：一项多机构研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-09-23 DOI:10.1002/lio2.70246

Mirabelle Sajisevi, Kenny Nguyen, Peter Callas, Andrew J. Holcomb, Emre Vural, Kyle P. Davis, Carissa M. Thomas, John S. Stein, Ameya Asarkar, Ricardo Aulet, Rebecca K. Bell, Michael A. Blasco, Vanessa B. Bowmaster, Clayton P. Burruss, Jeffson Chung, Kimberly Chan, Brent A. Chang, Charles S. Coffey, David M. Cognetti, Dylan J. Cooper, Joehassin Cordero, John Donovan, Yue Jennifer Du, Yusuf Dundar, Rogerio Dedivitis, Heather Edwards, Boban M. Erovic, Antoine Eskander, Philip A. Feinberg, Emily A. Garvey, David Goldstein, Joseph F. Goodman, Rafael N. Goulart, Neerav Goyal, Stefan Grasl, Jonathan Giurintano, Nikita Gupta, Andy Habib, Trevor Hackman, Jared H. Hara, Christina Henson, Michael L. Hinni, Nadia Hua, Stephanie Johnson-Obaseki, Aditya Juloori, Noah S. Kalman, Alexandra Kejner, Sobia F. Khaja, Jamie A. Ku, Arnaud Lambert, Bao K. Luu, Kelly R. Magliocca, Luiz R. Medina dos Santos, Cara Michael, Brett Miles, Giulianno Molina de Melo, Michael G. Moore, Gregoire B. Morand, Kauê Moura, Hesameddin Noroozi, Rusha Patel, Joseph Paydarfar, Karolina A. Plonowska-Hirschfeld, Nader Sadeghi, Fabrice Savaria, Nicole C. Schmitt, Justin Shapiro, Timothy B. Shaver, Sandro J. Stoeckli, William Alvo Stokes, Anita Sulibhavi, Jason Tasoulas, Varun Vendra, Daniel B. Vinh, Celina G. Virgen, Neil M. Woody, Geoffrey D. Young, Kiran Kakarala, Danny J. Enepekides, Michael P. Hier, Louise Davies, William R. Ryan

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引用次数: 0

摘要

目的：在治疗指南出台之前，探讨中低级别唾液腺癌治疗的实践模式和结果。方法：分析2010年至2019年期间因中低级别癌接受腮腺和颌下腺切除术的登记患者。结果：在纳入研究的所有786例患者中，726例（92%）进行了术前影像学检查，653例（83%）进行了术前活检。在729例腮腺癌患者中，大多数接受了浅表（n = 384, 53%）或全部（n = 254, 35%）腮腺切除术。在保留面神经的患者中，腮腺全切除术与短暂性面肌无力显著增加（72/177（41%）比82/311 (26%),RR 0.65, 95% CI 0.50-0.84, p p p p = 0.06）或区域控制率（RR 0.75, 95% CI 0.26-2.13, p = 0.58）相关。结论：从2010年到2019年，中低级别唾液癌的管理是可变的，考虑到疾病的稀缺性和异质性，以及2021年之前缺乏治疗指南，这是意料之中的。大多数腮腺恶性肿瘤患者行表面或全腮腺切除术。腮腺切除术的程度对面神经功能的预后有影响。随着时间的推移，辅助辐射的递送呈下降趋势。这里提供的数据将支持指南的传播，并为未来的试验提供数据。证据等级：2b。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

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Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study

Objectives

To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.

Methods

Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.

Results

Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, p = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, p = 0.58).

Conclusions

Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials.