目的:多形性腺瘤(CXPA)是一种罕见的原发性涎腺恶性肿瘤,通常由预先存在的多形性腺瘤引起。本系统综述研究了影响主要和次要唾液腺CXPA总生存期(OS)的预后因素。
方法:MEDLINE的系统评价,科克伦,Scopus,WebofScience,CINAHL,和开放灰色数据库,从开始到2022年3月31日,所有与“癌,多形性腺瘤”有关的英语文献。所有研究类型的主要和次要唾液腺CXPA患者均有资格纳入。
结果:在8143项研究中,纳入了符合纳入标准的39项研究(n=5637例患者)。中位OS为1,三,五,十年是90.0%,72.0%,61.9%,所有CXPA分别为45.0%和45.0%。更高的分期,T级,结节性疾病,分级,侵袭≥1.5mm的结果更差。组织学亚型,神经周浸润,和放疗没有显示一致的趋势。三项研究被评估为具有高偏倚风险,并被删除用于敏感性分析。
结论:所有唾液腺CXPA的生存结局随时间恶化。需要进一步研究组织病理学特征和放射治疗的实用性,以指导患者选择更积极的治疗。
背景:CRD42021238544(PROSPERO)。
OBJECTIVE: Carcinoma ex
Pleomorphic Adenoma (CXPA) is a rare primary salivary gland malignancy, typically arising from a pre-existing
pleomorphic adenoma. This systematic
review examines prognostic factors affecting overall survival (OS) in major and minor salivary gland CXPA.
METHODS: Systematic
review of MEDLINE, Cochrane, Scopus, Web of Science, CINAHL, and Open Grey databases from inception to 31st March 2022 for all English-language literature pertaining to \'carcinoma ex
pleomorphic adenoma\'. All study types with greater than five patients with CXPA of the major and minor salivary glands were eligible for inclusion.
RESULTS: Of 8143 studies, 39 studies (n = 5637 patients) meeting the inclusion criteria were included. Median OS at one, three, five, and ten years were 90.0 %, 72.0 %, 61.9 %, and 45.0 % respectively for all CXPA. Higher staging, T stage, nodal disease, grading, and invasion ≥ 1.5 mm had worse outcomes. Histological subtype, perineural invasion, and radiotherapy did not demonstrate a consistent trend. Three studies were evaluated to have high risk of bias, and was removed for sensitivity analysis.
CONCLUSIONS: Survival outcomes worsen with time for all salivary gland CXPA. Further research on histopathological features and the utility of radiation therapy is required to guide patient selection for more aggressive treatment.
BACKGROUND: CRD42021238544 (PROSPERO).