硬腭小涎腺癌的疗效评价和预后因素分析

背景与目的:硬腭小涎腺癌由于发病率低、长期生存率较高,使评价其治疗效果及预后因素较为困难。本研究目的是分析硬腭小涎腺癌的治疗效果及影响预后的因素。方法:对1964年～2001年在中山大学肿瘤防治中心住院治疗的96例原发于硬腭的小涎腺癌进行回顾性分析。应用Kaplan-Meier法计算累积生存率,各因素间比较用秩和对数检验(log-rank),多因素分析采用Cox模型。结果:本组96例患者总的5年、10年生存率分别为65.60%和47.90%。单纯手术治疗53例和手术加放疗35例的5年生存率分别为73.14%和66.58%,10年生存率分别为67.40%和46.60%。多因素分析结果表明:年龄≥50岁、肿瘤≥3cm、切缘阳性及肿瘤复发者预后差(P<0.05)。结论:手术治疗或以手术为主的综合治疗是硬腭小涎腺癌的首选治疗方法。年龄、肿瘤大小、切缘情况及复发情况为影响预后的独立因素。

Effectiveness evaluation and prognostic factor analysis in patients with minor salivary gland carcinoma of the hard palate

BACKGROUND & OBJECTIVE: Minor salivary gland carcinoma of the hard palate is rare, and its long-term survival rate is high, making it difficult to evaluate the prognostic factors and the efficacy of treatment. This study was designed to evaluate the efficacy of treatment and investigate the prognostic factors of minor salivary gland carcinoma of the hard palate. METHODS: Ninety-six cases of minor salivary gland carcinoma of the hard palate hospitalized in Cancer Center, Sun Yat-sen University, from 1964 to 2001 were reviewed retrospectively. The cumulative survival rate was analyzed by Kaplan-Meier method. The factors were compared using the log-rank test. The influencing factors were screened by Cox proportional hazards model. RESULTS: The 5- and 10-year overall survival rates were 65.60% and 47.90%, respectively. The 5- and 10-year disease-specific survival rates for the patients treated with surgery (53 cases) and surgery + radiotherapy (35 cases) were 73.14%, 67.40% and 66.58%,46.60%,respectively. Multivariate analysis showed that age >or=50 years old,tumor size >or=3 cm,surgical margin status,and recurrence were independently associated with decreased survival rates (P< 0.05). CONCLUSION: Surgery or surgery dominated multi-modality therapy was the principal treatment modality for minor salivary gland carcinoma of the hard palate. Age >or=50 years old, tumor size >or=3 cm, surgical margin status, and recurrence are independent factors affecting the prognosis.