大唾液腺癌37例の臨床検討

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  • A Clinical Study of 37 Cases of Major Salivary Gland Carcinomas
  • リンショウ ダイ ダエキセンガン 37レイ ノ リンショウ ケントウ

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Thirty-seven cases of major salivary gland carcinomas, treated in our hospital during the past 16 years from July 1995 to June 2011, were studied and reviewed histopathologically and statistically. They comprised 27 cases with parotid carcinomas and 10 cases with submandibular carcinomas. Thirty-five patients had undergone surgery, followed by chemotherapy in 7 patients and radiation therapy in 20. Because of the advanced ages of two patients in their 90’s with submandibular carcinoma, they were treated with radiation alone. The mean age of the group was 62.1 years. There was no difference based on sex and the side of occurrence. The mean duration of the complaint was 33.6 months, and the mean tumor diameter was 34.6 mm. The results of cytological examinations from 35 cases with fine-needle aspiration biopsy delivered a sensitivity of 62.9% and a false-negative rate of 37.1%.<br> Histopathological findings revealed the numbers of carcinoma ex pleomorphic adenoma as the greatest in all cases, salivary duct carcinoma in parotid carcinomas and also carcinoma ex pleomorphic adenoma in submandibular carcinomas. The mean operation time was 171.7 minutes and the mean intraoperative blood loss was 125.5 ml. In both parameters there was a statistically significant correlation. The complication with the highest postoperative rate was facial nerve palsy (37%). The 5-year cause-specific survival rate (CSS) was 78.5% in all cases, and 80.7% in parotid carcinomas and 72.9% in submandibular carcinomas, although these latter rates were without statistical significance. On the other hand according to the classifications of the stage of the cancer, the 5-year CSSs were 100% for Stage I, 80% for Stage II, 50% for Stage III, and 71.2% for Stage IV. Furthermore patients with parotid carcinomas with facial nerve palsy at the first time of diagnosis or in the category of the high malignancy group revealed significantly bleaker survival rates than those without.<br>

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