Abstract：
OBJECTIVE: Acinic cell carcinoma (ACC) most frequently arises in the parotid gland. Treatment consists of surgical resection and sometimes adjuvant therapy. ACC is most often a low-grade malignancy with good prognosis. Higher-grade tumors are often treated aggressively with total parotidectomy, neck dissection, and adjuvant therapy; however, the effect of parotid gland resection extent on oncologic outcomes has not been studied. Herein, we examine predictors of oncologic outcomes, including the effect of extent of resection.
METHODS: Patients with diagnosis of parotid ACC treated at our institution were included in this retrospective study. Patient factors were examined, and patients were grouped by extent of resection and tumor grade.
RESULTS: 58 patients, including 32 low-grade, 7 intermediate-grade, and 14 high-grade were included. Patients with low-grade tumors were more likely to undergo lesser extent of parotidectomy and less likely to undergo neck dissection. Two patients with low grade tumors developed recurrence, one local and one regional. Recurrence rate did not differ with resection extent in low-grade tumors. High tumor grade was found to be associated with disease progression. There was no association with adjuvant treatment and outcomes. Across all tumor grades advanced AJCC stage was found to be associated with disease progression.
CONCLUSIONS: In ACC patients with low-grade tumors and lower disease stage who undergo lesser extent of surgical resection oncologic outcomes were favorable. Patients with high-grade tumors carry a high risk of recurrence, despite aggressive treatment. AJCC stage and histopathologic grade may predict outcomes and guide treatment.
METHODS: Patients with diagnosis of parotid ACC treated at our institution were included in this retrospective study. Patient factors were examined, and patients were grouped by extent of resection and tumor grade.
RESULTS: 58 patients, including 32 low-grade, 7 intermediate-grade, and 14 high-grade were included. Patients with low-grade tumors were more likely to undergo lesser extent of parotidectomy and less likely to undergo neck dissection. Two patients with low grade tumors developed recurrence, one local and one regional. Recurrence rate did not differ with resection extent in low-grade tumors. High tumor grade was found to be associated with disease progression. There was no association with adjuvant treatment and outcomes. Across all tumor grades advanced AJCC stage was found to be associated with disease progression.
CONCLUSIONS: In ACC patients with low-grade tumors and lower disease stage who undergo lesser extent of surgical resection oncologic outcomes were favorable. Patients with high-grade tumors carry a high risk of recurrence, despite aggressive treatment. AJCC stage and histopathologic grade may predict outcomes and guide treatment.
摘要：
目的：腺泡细胞癌（ACC）最常见于腮腺。治疗包括手术切除和有时辅助治疗。ACC通常是具有良好预后的低度恶性肿瘤。高级别肿瘤通常采用全腮腺切除术积极治疗，颈淋巴结清扫术,和辅助治疗；然而，腮腺切除程度对肿瘤学结局的影响尚未研究.在这里，我们检查肿瘤结果的预测因子，包括切除程度的影响。
方法：本回顾性研究纳入我院诊断为腮腺ACC的患者。检查患者因素，根据切除程度和肿瘤分级对患者进行分组.
结果：58例患者，包括32个低等级，7个中级，包括14名高年级学生。患有低度肿瘤的患者更有可能接受较小程度的腮腺切除术，而不太可能接受颈部清扫术。两名低度肿瘤患者复发，一个地方和一个地区。低级别肿瘤的复发率与切除程度没有差异。发现高肿瘤分级与疾病进展相关。与辅助治疗和结果无关。在所有肿瘤等级中,发现晚期AJCC阶段与疾病进展相关。
结论：在接受手术切除程度较低的低级别肿瘤和疾病分期较低的ACC患者中，肿瘤预后良好。高级别肿瘤患者具有很高的复发风险，尽管积极的治疗。AJCC分期和组织病理学分级可以预测结果并指导治疗。
方法：本回顾性研究纳入我院诊断为腮腺ACC的患者。检查患者因素，根据切除程度和肿瘤分级对患者进行分组.
结果：58例患者，包括32个低等级，7个中级，包括14名高年级学生。患有低度肿瘤的患者更有可能接受较小程度的腮腺切除术，而不太可能接受颈部清扫术。两名低度肿瘤患者复发，一个地方和一个地区。低级别肿瘤的复发率与切除程度没有差异。发现高肿瘤分级与疾病进展相关。与辅助治疗和结果无关。在所有肿瘤等级中,发现晚期AJCC阶段与疾病进展相关。
结论：在接受手术切除程度较低的低级别肿瘤和疾病分期较低的ACC患者中，肿瘤预后良好。高级别肿瘤患者具有很高的复发风险，尽管积极的治疗。AJCC分期和组织病理学分级可以预测结果并指导治疗。
