目的:原发性腮腺鳞状细胞癌(pPSCC)是一种罕见的肿瘤,占所有腮腺癌的不到3%。对这种肿瘤的治疗没有普遍的共识,由于pPSCC的临床经验很少。此外,pPSCC常被误诊为转移性皮肤癌。在我们的研究中,我们专注于评估其生物学和临床特征,治疗结果和预后。我们提出了pPSCC诊断和治疗管理的更新。
方法:回顾性队列包括2008年至2022年在三个三级头颈中心诊断和治疗pPSCC的18例患者。在分析我们自己和以前发表的数据后,我们回顾性评估了他们的预后并建立了治疗建议。
结果:18例肿瘤中有14例诊断为IV期。5年总生存期为36个月。6例患者接受姑息治疗。12例患者接受了腮腺切除术,颈淋巴结清扫术,和辅助放疗。8例患者获得缓解(随访间隔3-56个月)。一名患者死于复发性疾病。其他人还活着,并且完全缓解。
结论:pPSCC的明确诊断必须符合组织学和临床标准。首先,必须排除肿瘤的转移来源.这种侵袭性肿瘤的5年生存率不超过50%。没有手术,预后较差。最好的结果,不论肿瘤分期,是通过手术实现的。因此,腮腺全切除术,颈淋巴结清扫术(治疗性或选择性)和辅助放疗适用于所有可切除的肿瘤。
OBJECTIVE: Primary squamous cell carcinoma of the parotid gland (pPSCC) is a rare tumor, accounting for less than 3% of all parotid carcinomas. There is no general consensus on the management of this tumor, since clinical experience for pPSCC is minimal. Moreover, pPSCC is often misdiagnosed for metastatic cutaneous carcinoma. In our study, we focused on evaluating its biological and clinical characteristics, treatment results and prognosis. We proposed an update on diagnostic and therapeutic management of pPSCC.
METHODS: The retrospective cohort included 18 patients diagnosed and treated for pPSCC in three tertiary head and neck centers between 2008 and 2022. We retrospectively evaluated their prognosis and established a therapeutic recommendation after analyzing our own and previously published data.
RESULTS: Fourteen of 18 tumors were diagnosed in stage IV. Five-year overall survival was 36 months. Six patients received palliative therapy. Twelve patients underwent parotidectomy, neck dissection, and adjuvant radiotherapy. Remission was achieved in 8 patients (follow-up interval 3-56 months). One patient died with recurrent disease. The others are alive and in complete remission.
CONCLUSIONS: The definitive diagnosis of pPSCC must meet the histological and clinical criteria. First of all, the metastatic origin of the tumor must be excluded. Five-year survival of this very aggressive tumor does not exceed 50%. Without surgery, the prognosis is poor. The best results, irrespective of tumor stage, are achieved with surgery. Therefore, a total parotidectomy, neck dissection (therapeutic or elective) and adjuvant radiotherapy are indicated for all resectable tumors.