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Abstract：
OBJECTIVE: The prognostic value of primary tumor surgery (PTS) in minor salivary-gland carcinoma (MiSGC) with distant metastasis (DM) at diagnosis has never been investigated. In this study, we aimed to provide the first evidence.
METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was employed to identify MiSGC patients with DM at diagnosis. The prognostic value of PTS was evaluated by Kaplan-Meier methods, log-rank analyses, and multivariate Cox proportional-hazard regression models.
RESULTS: Of the 152 eligible patients included in our study, 50 (32.9%) had undergone PTS. Kaplan-Meier analyses showed that the PTS group had >20% increase in 1- and 2-year overall survival (OS) and cancer-specific survival (CSS) compared with their counterparts without PTS (PTS group vs no-PTS group, 1-year OS 66.1% vs 43.9%, 1-year CSS 69.9% vs 44.9%, 2-year OS 56.6% vs 24.2%, 2-year CSS 59.9% vs 25.7%). Compared with the no-PTS group, multivariate analyses also demonstrated a significantly decreased risk of overall mortality (HR 0.601, 95% CI 0.379-0.952; P=0.031) and cancer-specific mortality (HR 0.547, 95% CI 0.336-0.891; P=0.015) in the PTS group. Subgroup multivariate analyses revealed patients with T1-T3 oropharynx, nasal cavity, or paranasal sinus primary MiSGC, especially adenoid cystic carcinoma, might benefit from PTS (all P<0.05).
CONCLUSIONS: PTS is associated with improved survival in highly selected MiSGC patients and may be considered in future clinical practice. However, prospective studies with larger sample size are still necessary to validate our findings.
METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was employed to identify MiSGC patients with DM at diagnosis. The prognostic value of PTS was evaluated by Kaplan-Meier methods, log-rank analyses, and multivariate Cox proportional-hazard regression models.
RESULTS: Of the 152 eligible patients included in our study, 50 (32.9%) had undergone PTS. Kaplan-Meier analyses showed that the PTS group had >20% increase in 1- and 2-year overall survival (OS) and cancer-specific survival (CSS) compared with their counterparts without PTS (PTS group vs no-PTS group, 1-year OS 66.1% vs 43.9%, 1-year CSS 69.9% vs 44.9%, 2-year OS 56.6% vs 24.2%, 2-year CSS 59.9% vs 25.7%). Compared with the no-PTS group, multivariate analyses also demonstrated a significantly decreased risk of overall mortality (HR 0.601, 95% CI 0.379-0.952; P=0.031) and cancer-specific mortality (HR 0.547, 95% CI 0.336-0.891; P=0.015) in the PTS group. Subgroup multivariate analyses revealed patients with T1-T3 oropharynx, nasal cavity, or paranasal sinus primary MiSGC, especially adenoid cystic carcinoma, might benefit from PTS (all P<0.05).
CONCLUSIONS: PTS is associated with improved survival in highly selected MiSGC patients and may be considered in future clinical practice. However, prospective studies with larger sample size are still necessary to validate our findings.
摘要：
目的：原发性肿瘤手术（PTS）在诊断时伴远处转移（DM）的小唾液腺癌（MiSGC）中的预后价值从未被研究过。在这项研究中,我们旨在提供第一个证据。
方法：监测，流行病学,和最终结果（SEER）数据库用于识别诊断时患有DM的MiSGC患者。通过Kaplan-Meier方法评估PTS的预后价值，对数秩分析，和多变量Cox比例风险回归模型。
结果：在我们研究的152名符合条件的患者中，50人（32.9%）接受了PTS。Kaplan-Meier分析显示，与没有PTS的同行相比，PTS组的1年和2年总生存率（OS）和癌症特异性生存率（CSS）增加了>20％（PTS组vs无PTS组，1年操作系统66.1%对43.9%，1年CSS69.9%对44.9%，两年操作系统56.6%对24.2%，2年CSS59.9%对25.7%）。与非PTS组相比，多变量分析还显示PTS组的总死亡率(HR0.601,95%CI0.379-0.952;P=0.031)和癌症特异性死亡率(HR0.547,95%CI0.336-0.891;P=0.015)的风险显著降低。亚组多变量分析显示T1-T3口咽患者，鼻腔,或鼻旁窦原发性MiSGC，尤其是腺样囊性癌,可能受益于PTS（均P<0.05）。
结论：PTS与高度选择的MiSGC患者的生存率提高相关，可在未来的临床实践中加以考虑。然而,仍有必要进行更大样本量的前瞻性研究来验证我们的研究结果.
方法：监测，流行病学,和最终结果（SEER）数据库用于识别诊断时患有DM的MiSGC患者。通过Kaplan-Meier方法评估PTS的预后价值，对数秩分析，和多变量Cox比例风险回归模型。
结果：在我们研究的152名符合条件的患者中，50人（32.9%）接受了PTS。Kaplan-Meier分析显示，与没有PTS的同行相比，PTS组的1年和2年总生存率（OS）和癌症特异性生存率（CSS）增加了>20％（PTS组vs无PTS组，1年操作系统66.1%对43.9%，1年CSS69.9%对44.9%，两年操作系统56.6%对24.2%，2年CSS59.9%对25.7%）。与非PTS组相比，多变量分析还显示PTS组的总死亡率(HR0.601,95%CI0.379-0.952;P=0.031)和癌症特异性死亡率(HR0.547,95%CI0.336-0.891;P=0.015)的风险显著降低。亚组多变量分析显示T1-T3口咽患者，鼻腔,或鼻旁窦原发性MiSGC，尤其是腺样囊性癌,可能受益于PTS（均P<0.05）。
结论：PTS与高度选择的MiSGC患者的生存率提高相关，可在未来的临床实践中加以考虑。然而,仍有必要进行更大样本量的前瞻性研究来验证我们的研究结果.
