Adjuvan Radyoterapi İle Tedavi Edilen Baş-Boyun Bölgesi Mukoepidermoid Karsinomlu Hastalarda Sağkalım Sonuçları ve Prognozu Etkileyen Faktörler
Abstract
Amaç: Bu çalışmanın amacı, baş ve boyun bölgesi yerleşimli majör ve minör tükürük bezlerinden kaynaklanan mukoepidermoid karsinom (MEC) nedeniyle cerrahi olan ve ameliyat sonrası radyoterapi uygulanan hastaların sonuçlarıyla bağlantılı klinik ve patolojik faktörleri belirlemekti.
Gereç ve Yöntem: Bu retrospektif çalışmada, baş ve boyundaki majör ve minör tükürük bezlerinde MEC nedeniyle cerrahi ve ardından radyoterapi uygulanan 42 hastanın tıbbi kayıtları, genel sağkalımın klinikopatolojik belirleyicilerini tanımlamak için analiz edildi. İkincil sonlanım noktaları lokal-bölgesel kontrol, uzak metastazsız sağkalım ve hastalıksız sağkalımı kapsamaktaydı.
Bulgular: Hasta kohortunun medyan yaşı 56 olup, %52,4'ü erkek ve %47,6'sı kadındı. Ortanca takip süresi 36 ay olup, aralık 6 ila 88 ay arasındaydı. Tüm hastalara küratif cerrahi ve ardından adjuvan radyoterapi uygulandı. Genel sağkalım (OS), lokal-bölgesel nükssüz sağkalım (LRFS), uzak metastazsız sağkalım (DMFS) ve hastalıksız sağkalım (DFS) için 2 yıllık ve 5 yıllık oranlar sırasıyla %92 ve %72,6, %92,2 ve %85,6, %84,8 ve %73, %82 ve %67,3 idi. Sadece histolojik grade istatistiksel olarak anlamlı bir prognostik faktör olarak bulundu ve hem OS (p=0.019), hem DMFS (p=0.014), hem de DFS'yi (p=0.044) etkiledi.
Sonuç: Tümörün histolojik derecesi MEC olgularının sonuçlarını etkileyen en önemli belirleyicidir. Adjuvan radyoterapi yüksek dereceli tümörler için önerilirken, düşük dereceli ve orta dereceli tümörler için uygulanması beklenen nüks riskine göre bireyselleştirilmelidir. Bu durum, tedavi yaklaşımlarının histolojik özelliklere göre uyarlanmasının önemini vurgulamaktadır.
References
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Survival Outcomes and Factors Affecting Prognosis in Patients with Head and Neck Region Mucoepidermoid Carcinoma Treated with Adjuvant Radiotherapy
Abstract
Aim: This study aims to ascertain the clinical and pathological factors linked to the outcomes of patients subjected to surgical intervention and postoperative radiotherapy for mucoepidermoid carcinoma (MEC) originating from both major and minor salivary glands in the head and neck region.
Material and Method: In this retrospective review, medical records of 42 patients who underwent surgery and subsequent radiotherapy for localized MEC in the major and minor salivary glands of the head and neck were analyzed to identify clinicopathological determinants of overall survival. Secondary endpoints encompassed local-regional control, distant metastasis-free survival, and disease-free survival.
Results: The median age of the patient cohort was 56 years, comprising 52.4% males and 47.6% females. The median follow-up period spanned 36 months, with a range of 6 to 88 months. All patients underwent curative surgery, followed by adjuvant radiotherapy. The 2-year and 5-year rates for overall survival (OS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 92% and 72.6%, 92.2% and 85.6%, 84.8% and 73%, 82% and 67.3%, respectively. Notably, only histologic grade emerged as a statistically significant prognostic factor, influencing both OS (p=0.019), DMFS (p=0.014), and DFS (p=0.044).
Conclusion: The histologic grade of the tumor is the foremost determinant impacting the outcomes of MEC cases. Adjuvant radiotherapy is recommended for high-grade tumors, while its application for low-grade and intermediate-grade tumors should be individualized based on the anticipated risk of recurrence. This underscores the significance of tailoring treatment approaches according to histologic characteristics.
Keywords
Mucoepidermoid carcinoma Salivary glands Head and neck cancer Histological grade Radiotherapy
References
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- 2. Spiro RH. Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg 1986;8:177- 84.
- 3. Duzova M, Turkan TS. Survival Outcomes and Prognostic Factors in Salivary Gland Cancers Treated by Surgery and Adjuvant Radiotherapy. Namik Kemal Tip Dergisi, 2021, 9.2.
- 4. Luna MA. Salivary mucoepidermoid carcinoma: revisited. Adv Anat Pathol 2006;13:293-307.
- 5. Goode RK, Auclair PL, Ellis GL. Mucoepidermoid carcinoma of the major salivary glands: clinical and histopathologic analysis of 234 cases with evaluation of grading criteria. Cancer 1998;82:1217-24.
- 6. Rapidis AD, Givalos N, Gakiopoulou H, et al. Mucoepidermoid carcinoma of the salivary glands. Review of the literature and clinicopathological analysis of 18 patients. Oral Oncol 2007;43:130-6.
- 7. Nance MA, Seethala RR, Wang Y, et al. Treatment and survival outcomes based on histologic grading in patients with head and neck mucoepidermoid carcinoma. Cancer 2008;113:2082- 9.
- 8. Chen AM, Lau VH, Farwell DG, Luu Q, Donald PJ. Mucoepidermoid carcinoma of the parotid gland treated by surgery and postoperative radiation therapy: clinicopathologic correlates of outcome. Laryngoscope 2013;123:3049-55.
- 9. Saygili U, Gulbeyaz C. The Effect of Navigation Program on Fatigue and Insomnia in Patients Receiving Head and Neck Radiotherapy. Journal of General Medicine. 2021, 31.4: 423-429.
- 10. Pires FR, Pringle GA, de Almeida OP, Chen SY. Intra-oral minor salivary gland tumors: a clinicopathological study of 546 cases. Oral Oncol 2007;43:463–70. http://dx.doi.org/10.1016/j.oraloncology.2006.04.008.
- 11. Ve´ drine PO, Coffinet L, Temam S, Montagne K, Lapeyre M, Oberlin O, et al. Mucoepidermoid carcinoma of salivary glands in the pediatrics age group: 18 clinical cases, including 11 second malignant neoplasms. Head Neck 2006;28:827–33. http://dx.doi.org/10.1002/hed.20429.
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- 13. Russell JL, Chen NW, Ortiz SJ, Schrank TP, Kuo YF, Resto VA. Racial and ethnic disparities in salivary gland cancer survival. JAMA Otolaryngol -Head Neck Surg 2014;140:504–12. http://dx.doi.org/10.1001/jamaoto.2014.406.
- 14. Baddour HM, Fedewa SA, Chen AY. Five- and 10-year cause-specific survival rates in carcinoma of the minor salivary gland. JAMA Otolaryngol Head Neck Surg 2016;142:67–73. http://dx.doi.org/10.1001/jamaoto.2015.2805.
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- 16. Chen MM, Roman SA, Sosa JA, Judson BL. Histologic grade as prognostic indicator for mucoepidermoid carcinoma: a population-level analysis of 2400 patients. Head Neck. 2014;36:158–63. http://dx.doi.org/10.1002/hed.23256.
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- 19. Ghosh-Laskar S, Murthy V, Wadasadawala T, et al. Mucoepidermoid carcinoma of the parotid gland: factors affecting outcome. Head Neck. 2011;33:497-503.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Oncology |
| Journal Section | Original Research |
| Authors | |
| Publication Date | September 30, 2023 |
| Acceptance Date | September 18, 2023 |
| Published in Issue | Year 2023 Volume: 13 Issue: 5 |
