高级阶段的治疗策略
Therapeutic strategy for advanced stages salivary carcinomas of the tongue: A multicenter REFCOR study
影响因子:3.90000
分区:医学2区 / 牙科与口腔外科2区 肿瘤学3区
发表日期:2024 Dec
作者:
Valentine Poissonnet, Emilien Chabrillac, Emmanuelle Uro-Coste, Virginie Woisard, Antoine Moya-Plana, Florent Espitalier, Joel Castelli, Thibault Dedieu, Sébastien Salas, Renaud Garrel, Robin Baudouin, Gilles Poissonnet, Claire Castain, Jonathan Barbut, Haitham Mirghani, Diane Evrard, Olivier Bouchain, Jean Paul Marie, Hélène Orliac, Philippe Ceruse, Xavier Dufour, Esteban Brenet, Audrey Rambeau, Philippe Herman, Yazan Abu Shama, Chloé Bertolus, Sarah Atallah, Sylvain Morinière, Christian Righini, François Mouawad, Suzy Duflo, Bertille Segier, Sébastien Vergez
摘要
舌头的唾液癌代表了一种治疗性挑战，因为它们的根本切除尤其令人沮丧。我们的目的是研究舌头的高级唾液癌的肿瘤学和功能结果。此回顾性的多中心研究基于法国国家的稀有头颈癌国家网络（REFCOR），包括所有T3-T4 T4-T4唾液瘤的患者，包括2009年1月2日在2018年1月2日诊断为47年的T3-T4唾液癌，47。In norly. Inter.in 4. Inter 47均包括在内。组织学主要是腺样性囊性癌（61.7％），其次是其他腺癌（27.7％）和粘膜皮质类癌（10.6％）。中位随访时间为63.9个月。在多变量分析中，手术与更好的无复发存活率显着相关（HR = 0.23，95％CI [0.09; 0.55]）和局部/区域无复发的生存率（HR = 0.31，95％CI [0.10; 0.95]）。随访结束时，手术组的远处转移率为61.9％，非手术组为57.7％。远处的无转移生存率为54.9％[38.3; 68.7]，两组之间没有统计差异。确定的胃抗抑制剂的发生率相似，但是手术组的正常口服饮食率似乎更高（38.1％vs 15.4％）。根本性的手术主要旨在改善局部/区域控制，这可能会导致更好的长期吞咽功能。这些肿瘤中约有一半可能与最初呈现时隐匿性转移有关。有必要进行更多的研究，以确定术后RT和并发CRT的非手术治疗的作用。
Abstract
Salivary carcinomas of the tongue represent a therapeutic challenge as their radical excision is particularly mutilating. We aimed to study the oncologic and functional outcomes of advanced stages salivary carcinomas of the tongue.This retrospective multicentric study, based on the French national network on rare head and neck cancers (REFCOR), included all patients with a T3-T4 salivary carcinoma of the tongue, diagnosed between January 2009 and December 2018.In total, 47 patients were included, of which 44.7 % underwent surgery. Histologies were mostly adenoid cystic carcinomas (61.7 %), followed by other adenocarcinomas (27.7 %) and mucoepidermoid carcinomas (10.6 %). Median follow-up duration was 63.9 months. In multivariable analysis, surgery was significantly associated with better Recurrence-Free Survival (HR = 0.23, 95 %CI [0.09;0.55]) and Local/Regional Recurrence-Free Survival (HR = 0.31, 95 %CI [0.10;0.95]). The rate of distant metastasis at the end of follow-up was 61.9 % in the surgical group and 57.7 % in the non-surgical group. The Distant Metastasis Free Survival was 54.9 % [38.3;68.7], without statistical difference between both groups. There were similar rates of definitive gastrostomies but the rate of normal oral diet at the last follow-up seemed higher in the surgery group (38.1 % vs 15.4 %).Radical surgery in that population mainly aims to improve local/regional control, which may result in better long-term swallowing functions. About half of these tumors may be associated with occult distant metastasis at initial presentation. More studies are warranted to establish the role of postoperative RT and non-surgical treatment with concurrent CRT.