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Abstract：
UNASSIGNED: This population-based study aims to assess the survival benefits of selective neck dissection (SND) compared to neck observation in patients with T1/T2N0M0 major salivary gland malignancy (MSGC).
UNASSIGNED: We conducted a retrospective review of T1/T2N0M0 MSGC patients who underwent primary tumor surgical extirpation with or without elective neck dissection in the Surveillance, Epidemiology, and End Results database (SEER) from 2004-2015. The impact of SND and clinical variables on overall survival (OS) and disease-specific survival (DSS) was evaluated using Univariate and Multivariate Cox proportional hazards regression models. Kaplan-Meier survival curves were generated, and survival rates were assessed via the log-rank test.
UNASSIGNED: Of 3778 post-operative T1-T2N0M0 MSGC patients, 2305 underwent elective neck dissection, while 1473 did not. Median follow-up was 106 months. Univariate and Multivariate analysis identified SND as a prognostic factor for OS in all the study population. After stratified analysis, we found that in the poorly high-grade (differentiated and undifferentiated) patients, the survival showed a significant OS and DSS benefit after receiving SND compared with the neck observations [HR for OS (95%CI): 0.571(0.446-0.731), P<0.001] and [HR for DSS (95%CI): 0.564(0.385-0.826), P=0.003], other than in the well differentiated or moderately differentiated subgroup. Especially, when the pathological is squamous cell carcinoma, the results show that the people underwent SND had better prognosis, not only in OS [HR (95%CI): 0.532(0.322-0.876), P=0.013], but also in DSS [HR (95%CI): 0.330(0.136-0.797), P=0.014]. The multivariate analysis also yielded encouraging results, compared with neck observation, receiving SND bought about a significant independent OS (adjusted HR, 0.555; 95% CI, 0.328-0.941; P=0.029) and DSS (adjusted HR, 0.349; 95% CI, 0.142-0.858; P=0.022) advantage in high grade squamous cell carcinoma MSGC patients. The Kaplan-Meier survival curves also demonstrated that adjusted SND still had significantly better OS(P=0.029) and DSS(P=0.022) than the observation group in patients with high-grade squamous cell carcinoma of MSGC.
UNASSIGNED: Poorly differentiated and undifferentiated T1/T2N0M0 major salivary gland malignancy treated with selective neck dissection demonstrated superior survival compared to neck observation, especially in the pathological subtype of squamous cell carcinoma. These findings suggest the potential benefits of multimodal therapy for appropriately selected patients, emphasizing significant clinical implications.
UNASSIGNED: We conducted a retrospective review of T1/T2N0M0 MSGC patients who underwent primary tumor surgical extirpation with or without elective neck dissection in the Surveillance, Epidemiology, and End Results database (SEER) from 2004-2015. The impact of SND and clinical variables on overall survival (OS) and disease-specific survival (DSS) was evaluated using Univariate and Multivariate Cox proportional hazards regression models. Kaplan-Meier survival curves were generated, and survival rates were assessed via the log-rank test.
UNASSIGNED: Of 3778 post-operative T1-T2N0M0 MSGC patients, 2305 underwent elective neck dissection, while 1473 did not. Median follow-up was 106 months. Univariate and Multivariate analysis identified SND as a prognostic factor for OS in all the study population. After stratified analysis, we found that in the poorly high-grade (differentiated and undifferentiated) patients, the survival showed a significant OS and DSS benefit after receiving SND compared with the neck observations [HR for OS (95%CI): 0.571(0.446-0.731), P<0.001] and [HR for DSS (95%CI): 0.564(0.385-0.826), P=0.003], other than in the well differentiated or moderately differentiated subgroup. Especially, when the pathological is squamous cell carcinoma, the results show that the people underwent SND had better prognosis, not only in OS [HR (95%CI): 0.532(0.322-0.876), P=0.013], but also in DSS [HR (95%CI): 0.330(0.136-0.797), P=0.014]. The multivariate analysis also yielded encouraging results, compared with neck observation, receiving SND bought about a significant independent OS (adjusted HR, 0.555; 95% CI, 0.328-0.941; P=0.029) and DSS (adjusted HR, 0.349; 95% CI, 0.142-0.858; P=0.022) advantage in high grade squamous cell carcinoma MSGC patients. The Kaplan-Meier survival curves also demonstrated that adjusted SND still had significantly better OS(P=0.029) and DSS(P=0.022) than the observation group in patients with high-grade squamous cell carcinoma of MSGC.
UNASSIGNED: Poorly differentiated and undifferentiated T1/T2N0M0 major salivary gland malignancy treated with selective neck dissection demonstrated superior survival compared to neck observation, especially in the pathological subtype of squamous cell carcinoma. These findings suggest the potential benefits of multimodal therapy for appropriately selected patients, emphasizing significant clinical implications.
摘要：
■这项基于人群的研究旨在评估T1/T2N0M0主要唾液腺恶性肿瘤（MSGC）患者的选择性颈部清扫术（SND）与颈部观察相比的生存益处。
■我们在监测中对T1/T2N0M0MSGC患者进行了回顾性审查，这些患者接受了原发性肿瘤手术切除，有或没有选择性颈淋巴结清扫术，流行病学,和2004-2015年的最终结果数据库(SEER)。使用单变量和多变量Cox比例风险回归模型评估SND和临床变量对总生存期（OS）和疾病特异性生存期（DSS）的影响。生成Kaplan-Meier存活曲线,生存率通过对数秩检验进行评估。
■3778例术后T1-T2N0M0MSGC患者，2305接受了选择性颈淋巴结清扫术，1473年没有。中位随访时间为106个月。单变量和多变量分析确定SND是所有研究人群中OS的预后因素。经过分层分析,我们发现，在低高级别（分化和未分化）患者中，与颈部观察结果相比，接受SND后的生存率显示出显著的OS和DSS获益[OS的HR（95CI）：0.571（0.446-0.731），P<0.001]和[DSS的HR（95CI）：0.564（0.385-0.826），P=0.003],除了高分化或中分化亚组。尤其是,当病理是鳞状细胞癌，结果表明，SND患者预后较好，不仅在操作系统中[HR（95CI）：0.532（0.322-0.876），P=0.013],而且在DSS中[HR（95CI）：0.330（0.136-0.797），P=0.014]。多变量分析也产生了令人鼓舞的结果，与颈部观察相比，接受SND购买了一个重要的独立操作系统(调整后的HR，0.555；95%CI，0.328-0.941；P=0.029）和DSS（调整后的HR，0.349；95%CI，0.142-0.858；P=0.022）在高级别鳞状细胞癌MSGC患者中优势。Kaplan-Meier生存曲线显示，在MSGC高级别鳞状细胞癌患者中，校正SND的OS(P=0.029)和DSS(P=0.022)明显优于观察组。
■选择性颈淋巴结清扫术治疗的低分化和未分化的T1/T2N0M0大涎腺恶性肿瘤与颈部观察相比具有更高的生存率，特别是在鳞状细胞癌的病理亚型中。这些研究结果表明，对于适当选择的患者，多模式治疗的潜在益处。强调重要的临床意义。
■我们在监测中对T1/T2N0M0MSGC患者进行了回顾性审查，这些患者接受了原发性肿瘤手术切除，有或没有选择性颈淋巴结清扫术，流行病学,和2004-2015年的最终结果数据库(SEER)。使用单变量和多变量Cox比例风险回归模型评估SND和临床变量对总生存期（OS）和疾病特异性生存期（DSS）的影响。生成Kaplan-Meier存活曲线,生存率通过对数秩检验进行评估。
■3778例术后T1-T2N0M0MSGC患者，2305接受了选择性颈淋巴结清扫术，1473年没有。中位随访时间为106个月。单变量和多变量分析确定SND是所有研究人群中OS的预后因素。经过分层分析,我们发现，在低高级别（分化和未分化）患者中，与颈部观察结果相比，接受SND后的生存率显示出显著的OS和DSS获益[OS的HR（95CI）：0.571（0.446-0.731），P<0.001]和[DSS的HR（95CI）：0.564（0.385-0.826），P=0.003],除了高分化或中分化亚组。尤其是,当病理是鳞状细胞癌，结果表明，SND患者预后较好，不仅在操作系统中[HR（95CI）：0.532（0.322-0.876），P=0.013],而且在DSS中[HR（95CI）：0.330（0.136-0.797），P=0.014]。多变量分析也产生了令人鼓舞的结果，与颈部观察相比，接受SND购买了一个重要的独立操作系统(调整后的HR，0.555；95%CI，0.328-0.941；P=0.029）和DSS（调整后的HR，0.349；95%CI，0.142-0.858；P=0.022）在高级别鳞状细胞癌MSGC患者中优势。Kaplan-Meier生存曲线显示，在MSGC高级别鳞状细胞癌患者中，校正SND的OS(P=0.029)和DSS(P=0.022)明显优于观察组。
■选择性颈淋巴结清扫术治疗的低分化和未分化的T1/T2N0M0大涎腺恶性肿瘤与颈部观察相比具有更高的生存率，特别是在鳞状细胞癌的病理亚型中。这些研究结果表明，对于适当选择的患者，多模式治疗的潜在益处。强调重要的临床意义。
