Prognostische Bedeutung klinisch-pathologischer Faktoren beim adenoidzystischen Karzinom des Kopf-Hals-Bereiches.Eine retrospektive Untersuchung am Patientengut der Klinik für Hals-, Nasen- und Ohrenheilkunde der Philipps-Universität Marburg
Loading...
Files
Date
relationships.isAuthorOf
Publisher
Philipps-Universität Marburg
item.page.supervisor-of-thesis
Abstract
Adenoid cystic carcinoma (ACC) of the head and neck is usually characterized by slow, local destroying and relentless growth. Due to its clinical appearance this rare malignancy occupies a special position within the group of head and neck malignancies. Despite various therapeutical efforts the prolonged clinical course of the ACC is still characterized by multiple local recurrences and distant metastases.
Prognostic factors play an important role in the comprehension of the ACC. According to the limited comparability of previous studies the prognostic value of many clinicopathological features is still discussed controversially.
The aim of the present study was to describe the features of the investigated patient group (n=35) and to determine the prognostic value of certain clinicopathological features which determine the clinical course of the ACC.
The present study confirms the prognostic value of tumour-free resection margins. The achievement of tumour-free resection margins was significantly associated with an higher disease-free (p=0.001) and overall survival rate (p=0.0088).
No statistical significant difference could be found between the galectin-3 negative and the galectin-3 positive group with respect to age at diagnosis, gender, tumour size, tumour growth pattern, tumour site and perineural invasion.
The disease-free survival and overall survival rate of the patients with galectin-3 positive tumours tended to be lower than that of patients with galectin-3 negative tumours, but did not reach statistical significance in the correlation of galectin- expression and the disease-free survival and overall survival rate. There was a significant difference between the galectin-3 negative and galectin-3 positive group with regard to the patients outcome.
Although optimal therapy for ACC has not been established to date, local radical excision combined with postoperative radiotherapy appears to decrease the local recurrence rate.
However, despite radical therapy distant metastases occur frequently even after years of local control resulting in a worse prognosis. Distant metastases are the main problem in the management of ACC of the head and neck.
Due to the high incidence of occult pulmonary metastases they should be included into the therapy of the primary cancer. To establish an effective therapeutic concept for ACC patients, besides the aggressive local therapy of the primary cancer, we think that it is important to identify high-risk patients for the development of distant metastases.
In the present study, galectin-3 expression was associated with the increased incidence of distant metastases in ACC of the head and neck. Further studies involving a larger patient population are required to provide more information regarding galectin-3 expression in ACC and its diagnostic accuracy in patients who have a high risk of distant metastases.
Review
Metadata
Contributors
Supervisor:
Dates
Created: 2007Issued: 2008-01-25Updated: 2011-08-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
AdenoidzystischACCAdenoid cystic, Cylindroma
DFG-subjects
CystadenocarcinomZylindrom
DDC-Numbers
610
show more
Pientka, Anna: Prognostische Bedeutung klinisch-pathologischer Faktoren beim adenoidzystischen Karzinom des Kopf-Hals-Bereiches.Eine retrospektive Untersuchung am Patientengut der Klinik für Hals-, Nasen- und Ohrenheilkunde der Philipps-Universität Marburg. : Philipps-Universität Marburg 2008-01-25. DOI: https://doi.org/10.17192/z2008.0002.
License
This item has been published with the following license: In Copyright