背景:腺泡细胞癌(ACC)是一种唾液腺恶性肿瘤,很少涉及鼻窦腔。可用于指导管理的成果数据有限。
目的:我们试图使用国家癌症数据库(NCDB)来表征鼻窦ACC的治疗结果。
方法:回顾性分析2004-2016年累及鼻窦腔的ACC患者的NCDB。人口统计,治疗,并获得了生存信息。未经调整的Kaplan-Meier估计,对数秩测试,采用多变量Cox比例风险模型评估总生存期(OS).
结果:共有28名患者被纳入分析,平均年龄为58.6±15.5岁。一半的患者(n=14,50%)是男性,大部分是白人(n=23,82.1%),以及私人保险(n=16,57.1%)。鼻腔是最常见的亚部位(n=18,64.3%),其次是上颌窦(n=5,17.9%)。大多数患者仅接受手术(n=17,60.7%),其余患者接受手术后接受放射治疗(n=8,28.6%),单独辐射(n=1,3.6%),无治疗(n=2,7.1%)。1-,5-,该队列的10年生存率为100%(95%CI:100%-100%),84.3%(95%CI:71.2%-99.7%),和72.2%(95%CI:55%-94.8%),分别。在多变量分析中,年龄较大与OS较差相关(风险比(HR):1.27;95%CI:1.11-1.46,P<.001).蝶窦疾病与较差的生存率相关(HR:198,95%CI:10.4-3,739,P<.001),并且在对数秩检验中,较大的肿瘤大小与较差的OS相关。但不是多变量分析。
结论:鼻窦ACC是一种罕见的实体,具有相对良好的长期结局。老年和原发性蝶窦疾病与较差的预后相关。大多数患者接受手术切除治疗。未来的研究需要评估放射治疗的最佳时机和适应症。
BACKGROUND: Acinic cell carcinoma (ACC) is a salivary gland malignancy that rarely can involve the sinonasal cavity. There are limited outcomes data available to guide management.
OBJECTIVE: We sought to use the National Cancer Database (NCDB) to characterize treatment outcomes in sinonasal ACC.
METHODS: A retrospective analysis of the NCDB from 2004 to 2016 for patients with ACC involving the sinonasal cavity was conducted. Demographic, treatment, and survival information were obtained. Unadjusted Kaplan-Meier estimates, log-rank tests, and a multivariable Cox proportional hazard model were used to assess overall survival (OS).
RESULTS: A total of 28 patients were included in the analysis with an average age of 58.6 ± 15.5 years. Half the patients (n = 14, 50%) were male, mostly white (n = 23, 82.1%), and with private insurance (n = 16, 57.1%). The nasal cavity was the most common subsite (n = 18, 64.3%), followed by the maxillary
sinus (n = 5, 17.9%). Most patient received surgery alone (n = 17, 60.7%), with the remaining patients undergoing surgery followed by radiation (n = 8, 28.6%), radiation alone (n = 1, 3.6%), and no treatment (n = 2, 7.1%). The 1-, 5-, and 10-year survival in this cohort was 100% (95% CI: 100%-100%), 84.3% (95% CI: 71.2%-99.7%), and 72.2% (95% CI: 55%-94.8%), respectively. On multivariate analysis, older age was associated with worse OS (hazard ratio (HR): 1.27; 95% CI: 1.11-1.46, P < .001). Disease of the sphenoid
sinus correlated with worse survival (HR: 198, 95% CI: 10.4-3,739, P < .001) and large tumor size was associated with worse OS on log-rank test, but not on multivariate analysis.
CONCLUSIONS: Sinonasal ACC is a rare entity with relatively good long-term outcomes. Older age and primary disease of the sphenoid
sinus are associated with worse outcomes. Most patients are treated with surgical resection. Future research is needed to assess the optimal timing and indications for radiation therapy.