PDF(Pubmed)
Abstract：
We conducted a retrospective, longitudinal study on a single-center series of patients who underwent parotidectomy in the management of advanced head and neck non-melanoma skin cancer (hnNMSC). The aim of this study was to identify prognostic factors associated with worse outcomes. Forty-one men and nine women were included. The mean age at the time of surgery was 78.9 years. The 5-year overall survival, disease-specific survival, locoregional recurrence-free survival, and distant metastasis-free survival calculated with Kaplan-Meier curves were 39.9%, 56.3%, 58.6%, and 82.1%, respectively. A univariate analysis showed that the status of the margins, facial nerve direct involvement, lymph vascular invasion, and histological grading were associated with worse outcomes (p < 0.05). Positive margins were associated with worse disease-specific survival also in a multivariate analysis (p = 0.001, HR = 32.02, and CIs 4.338 to 351.3). Because the resection in free margins is the most important prognostic factor, early diagnosis or, in the case of advanced disease, extensive surgical resection with concomitant reconstruction is needed. Adjuvant therapy is indicated in selected cases.
摘要：
我们做了一个回顾,对接受腮腺切除术治疗晚期头颈部非黑色素瘤皮肤癌(hnNMSC)患者的单中心系列纵向研究.这项研究的目的是确定与不良预后相关的预后因素。包括41名男性和9名女性。手术时的平均年龄为78.9岁。5年总生存率,疾病特异性生存，局部无复发生存，用Kaplan-Meier曲线计算的无远处转移生存率为39.9%，56.3%,58.6%,82.1%，分别。单因素分析表明，边缘的状态，面神经直接受累,淋巴血管浸润，和组织学分级与较差的预后相关(p<0.05)。在多变量分析中，阳性切缘也与较差的疾病特异性生存率相关（p=0.001，HR=32.02，CI=4.338至351.3）。因为游离切缘切除是最重要的预后因素，早期诊断或，在晚期疾病的情况下，需要进行广泛的手术切除并伴随重建。在选定的病例中需要辅助治疗。
