目前,神经周浸润被用作侵袭性唾液腺疾病的组织学指标。在其他头颈部恶性肿瘤中,神经周浸润会影响癌症病变的分期,因此会影响治疗方案。
目的比较伴有和不伴有神经周浸润的原发性腮腺恶性肿瘤的生存结果。系统评价来自任何原发性腮腺恶性肿瘤患者的科学文献数据,以调查神经周浸润患者的预后。
PubMed(Medline),从成立到2020年7月,Scopus和Cochrane数据库都在没有任何初始搜索限制的情况下进行了查询。从相关文章的审查中纳入了其他出版物。
我们的纳入标准包括原发性腮腺癌,据报道神经周浸润对生存结局的影响。排除标准是非英语文本,非人类研究,reviews,教科书,摘要,病例报告和病例系列。两位作者独立审查了纳入的文章。在最初的465条记录中,83篇文章进行了全面审查,最终收集了14项研究。
PRISMA-p指南用于我们的研究报告。还使用了MOOSE清单。应用MINORS标准评估偏倚风险。随机效应模型用于估计合并效应大小。我们的研究不需要机构审查委员会审查。
主要研究结果是在数据收集之前设定的,包括总生存期(OS),无病生存率(DFS),有和没有神经周侵袭的患者的疾病特异性生存率(DSS)和无远处转移生存率(DMFS)。
14项研究为这项荟萃分析做出了贡献。与无神经周侵犯的患者相比,合并死亡率(HR=3.64),复发时间(HR=3.56),PNI患者的疾病特异性死亡率(HR=2.77)和远处转移(HR=3.84)显著较高(均p<.001).控制神经周浸润状态,没有调节因素与这些生存结局相关(均p>.05).鉴于神经周浸润的临床严重程度,如一组发表偏倚图所示,很少有研究无效。
神经周浸润预示着腮腺恶性肿瘤患者的生存结局较差。
At present, perineural invasion is used as a histologic indicator of aggressive salivary gland disease. In other head and neck malignancies, perineural invasion impacts staging of cancer lesions and therefore affects treatment options.
To compare survival outcomes in primary parotid malignancies with and without perineural invasion.A systematic
review pooled data from the scientific literature in patients with any primary parotid malignancy to investigate the prognosis of those with perineural invasion.
PubMed (Medline), Scopus and Cochrane databases were queried from inception to July 2020 without any initial search constraints. Additional publications were included from
review of pertinent articles.
Our inclusion criteria included primary parotid cancers with reported perineural invasion on survival outcomes. Exclusion criteria were non-English language text, non-human studies, reviews, textbooks, abstracts, case reports and case series. Two authors independently reviewed articles for inclusion. Of the initial 465 records, 83 articles were reviewed in full to yield a final collection of 14 studies.
PRISMA-p guidelines were used in the reporting of our studies. A MOOSE Checklist was also used. MINORS criteria were applied to assess risk of bias. Random-effects models were used to estimate pooled effect sizes. No institutional
review board
review was needed for our study.
Primary study outcomes were set prior to data collection and included overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS) and distant-metastasis-free survival (DMFS) in patients with and without perineural invasion.
Fourteen studies contributed to this meta-analysis. Compared to patients without perineural invasion, the pooled rate of mortality (HR = 3.64), time to recurrence (HR = 3.56), disease-specific mortality (HR = 2.77) and distant metastasis (HR = 3.84) was significantly higher for patients with PNI (all p <.001). Controlling for perineural invasion status, no moderator was associated with these survival outcomes (all p >.05). Given the clinical severity of perineural invasion, few studies were null as shown in a panel of publication bias plots.
Perineural invasion portends a poor survival outcome in patients with parotid malignancies.