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Clinicopathological Parameters and Prognosis of Carcinoma ex Pleomorphic Adenoma

摘要


Background: Carcinoma ex pleomorphic adenoma (CexPA) is an uncommon tumor with aggressive behavior and poor clinical outcomes. This study aimed to evaluate the prognostic value of various clinicopathological parameters of the CexPA and the experience in treating the malignancy. Methods: This retrospective study recruited 36 patients with a diagnosis of CexPA in major and minor salivary glands and lacrimal glands between June, 2006 and April, 2016. It comprised of 20 males and 16 females. Patients' age at diagnosis ranged from 27 to 78 years old (mean = 57.52 ± 14.09). Results: History of previous surgeries in these CexPA patients did not increase the rates of perineural and lymphovascular invasion in tumor. Cox regression analysis showed that the age, sex, history of previous surgeries, tumor subsites, perineural and lymphovascular invasion and resection margin involvement did not influence the survival of CexPAs in both disease-free survival (DFS) and overall survival (OS) (p > 0.05). Using Kaplan-Meier analysis, the DFS was 60.0% at three years and 52.0% at five years. Distant metastasis specific survival was 66.0% at three years and 58.0% at five years and the OS was 90.0% at both three and five years. Conclusions: Ablative surgical resection is the main treatment modality for CexPA, which is preferably followed by adjuvant therapy. It provides an outcome not as gloomy as reported in the literature. No clinicopathological parameter was shown to be an independent predictor of prognosis.

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