耳下腺悪性腫よう７４例の臨床的検討―治療法と成績―

• 坂本 菊男

  久留米大学医学部耳鼻咽喉科•頭頸部外科学講座

• 千々和 秀記

  久留米大学医学部耳鼻咽喉科•頭頸部外科学講座

• 宮嶋 義巳

  久留米大学医学部耳鼻咽喉科•頭頸部外科学講座

• 梅野 博仁

  久留米大学医学部耳鼻咽喉科•頭頸部外科学講座

• 中島 格

  久留米大学医学部耳鼻咽喉科•頭頸部外科学講座

書誌事項

タイトル別名

• A Retrospective Study of Malignant Parotid Tumors
• ジカセン アクセイ シュヨウ 74レイ ノ リンショウテキ ケントウ チリョウホウ ト セイセキ
• 治療法と成績

抄録

The clinical features of 74 patients (39 men, 35 women; mean age, 62 years) with malignant parotid tumors were retrospectively investigated. According to the TNM Classification, 4 patients were classified as T1, 9 as T2, 6 as T3, and 55 as T4. Fifty cases were staged as N0, 9 as N1, 14 as N2 and 1 as N3. Tumors located in both lobes of the parotid gland were the most frequent type of tumor (49%). Twenty-four percent of the 74 patients exhibited facial nerve palsy before treatment. Facial palsy was found predominantly in cases with a higher T classification or with deep lobe occupation. Histopathologically, sixteen tumor types were observed; mucoepidermoid carcinoma was the most common.<br>The overall five-year and ten-year survival rates determined using the Kaplan-Meier method were 65% and 61%. The factors influencing a poor outcome were T4 classification (p=0.0189), an N+stage (p<0.0001), and facial palsy (p<0.0001). As for the major histopathologic types, the five-year survival rates were 69% for mucoepidermoid carcinoma, 48% for adenocarcinoma, 71% for adenoid cystic carcinoma, and 100% for acinic cell carcinoma and malignant mixed tumor.<br>With respect to the treatment modality, patients who were classified as T1 or T2 and whose tumors were located in the superficial lobe without facial nerve invasion could be satisfactorily treated with only a superficial lobectomy conserving the facial nerve. A total parotidectomy with total removal of the facial nerve seemed necessary for T3 and T4 cases, especially those with adenocarcinoma or mucoepidermoid carcinoma. Modified neck dissection may be necessary for N0 cases, especially those with adenocarcinoma, adenoid cystic carcinoma or undifferentiated carcinoma. Nerve grafting after total nerve resection is recommended for a better quality of life.

収録刊行物

• 日本耳鼻咽喉科学会会報

  日本耳鼻咽喉科学会会報 109 (2), 103-111, 2006

  一般社団法人 日本耳鼻咽喉科頭頸部外科学会

キーワード

• 耳下腺悪性腫瘍
• 病理組織型
• 治療法
• 顔面神経
• 治療成績

詳細情報

• CRID: 1390282679982087808
• NII論文ID: 10019255527
• NII書誌ID: AN00191551
• DOI: 10.3950/jibiinkoka.109.103
• COI: 1:STN:280:DC%2BD287ktFSlsw%3D%3D
• ISSN: 18830854
• ISSN: 00306622
• ISSN: http://id.crossref.org/issn/00306622
• NDL書誌ID: 7853554
• PubMed: 16529017
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I7853554
• Web Site: https://search.jamas.or.jp/link/ui/2006112204
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可