目的:探讨头颈部黏液表皮样癌(MEC)患者的预后因素,尤其是治疗方式对生存的影响。
方法:从监测中获得2000年至2015年的原发性头颈部MEC患者,流行病学,和结束结果(SEER)数据库。与总生存率(OS)和癌症特异性生存率(CSS)相关的预后因素,以及治疗的影响,通过多变量Cox回归分析进行评价。
结果:我们确定了2692例诊断为头颈部MEC的患者,其中1397人(51.89%)患有腮腺原发性,569人(22.14%)死亡,341例(12.67%)死于MEC。年龄较大(≥53岁),男性,未婚,收入较低,其他头部和颈部区域的肿瘤部位,肿瘤等级更高,肿瘤较大,较高的阶段与较差的OS和CSS有关。未接受手术的患者(HR=3.20,95%CI2.45-4.18)的OS较差,而部分器官切除和全器官切除对患者OS无显著差异(p=0.729)。对于联合治疗,仅接受放疗(HR=3.21,95%CI2.27-4.53)或未接受手术且未接受放疗(HR=2.59,95%CI1.83-3.67)的患者OS较差(vs.仅手术),但仅手术和手术联合放疗对患者的OS无显著差异(p=0.218)。对于CSS,相应结果与OS一致。
结论:手术切除可能是头颈部MEC更好的生存选择。
OBJECTIVE: To investigate prognostic factors in patients with head and neck Mucoepidermoid Carcinoma (MEC), especially the impact of treatment modalities on survival.
METHODS: Patients with primary head and neck MEC between 2000 and 2015 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors related to Overall Survival (OS) and Cancer-Specific Survival (CSS), as well as the impact of treatments, were evaluated by multivariable Cox regression analysis.
RESULTS: We identified 2692 patients diagnosed with head and neck MEC, of whom 1397 (51.89%) had a parotid gland primary, 569 (22.14%) died, and 341 (12.67%) died of MEC. Older age (≥53 years), males, unmarried, lower income, tumor site in other head and neck areas, higher tumor grade, larger tumor size, and higher stage were related to poorer OS and CSS. Patients who did not undergo surgery (HR=3.20, 95% CI 2.45‒4.18) had worse OS, while no significant difference was detected between partial and total organ excision on patients\' OS (p=0.729). For combination therapy, patients who received radiotherapy only (HR=3.21, 95% CI 2.27-4.53) or no surgery and no radiotherapy (HR=2.59, 95% CI 1.83-3.67) were correlated with worse OS (vs. surgery only), but no significant difference was detected between surgery only and surgery combined with radiotherapy on patients\' OS (p=0.218). For CSS, the corresponding results were consistent with OS.
CONCLUSIONS: Surgical resection only may be a better survival option for head and neck MEC.