Objective: Adenoid cystic carcinoma (ACC) is a rare malignant tumor that mainly arises in the head and neck area. We aimed to compare the long-term survival of patients with ACC based on their geographic regions within the United States using the Surveillance, Epidemiology, and End Results (SEER) registry data. Methods: We queried the SEER database to evaluate the geographic distribution of ACC patients based on inpatient admissions. The states included in the study were divided into four geographical regions (Midwest, Northeast, South, and West) based on the U.S. Census Bureau-designated regions and divisions. Demographic and clinical variables were compared between the groups. Kaplan–Meier curves and Cox regression were used to assess late mortality. Results: A total of 5150 patients were included (4.2% from the Midwest, 17.2% from the Northeast, 22.5% from the South, and 56.1% from the West regions). The median follow-up was 12.3 (95% CI: 11.6–13.1 years). Median overall survival was 11.0 (95% CI: 9.2-NR years), 14.3 (95% CI: 12.4–16.4 years), 11.3 (95% CI: 9.7–14.8 years), and 12.0 (95% CI: 11.3–13.0 years) for Midwest, Northeast, South, and West regions, respectively. In multivariable analysis, older age, male sex, thoracic cancer, the presence of regional and distal disease, receiving chemotherapy, not undergoing surgical resection, and being treated in the West vs. Northeast region were found to be independent predictors of poor survival. We identified a significant survival difference between the different regions, with the West exhibiting the worst survival compared to the Northeast region. Conclusions: In addition to the well-known predictors of late mortality in ACC (tumor location, stage, and treatment modalities), our study identified a lack of social support (being unmarried) and geographic location (West region) as independent predictors of late mortality in multivariable analysis. Further research is needed to explore the causal relationships.
目的：腺样囊性癌（ACC）是一种罕见的恶性肿瘤，主要发生于头颈部区域。本研究旨在利用美国监测、流行病学和最终结果（SEER）登记数据，比较美国不同地理区域ACC患者的长期生存情况。方法：我们检索了SEER数据库，基于住院记录评估ACC患者的地理分布。根据美国人口普查局指定的区域划分，将研究涵盖的州分为四个地理区域（中西部、东北部、南部和西部）。对各组间的人口统计学和临床变量进行了比较。采用Kaplan-Meier曲线和Cox回归分析评估远期死亡率。结果：共纳入5150例患者（中西部4.2%，东北部17.2%，南部22.5%，西部56.1%）。中位随访时间为12.3年（95% CI：11.6-13.1年）。中西部、东北部、南部和西部区域的中位总生存期分别为11.0年（95% CI：9.2-未达到）、14.3年（95% CI：12.4-16.4年）、11.3年（95% CI：9.7-14.8年）和12.0年（95% CI：11.3-13.0年）。多变量分析显示，年龄较大、男性、胸部肿瘤、存在区域性和远处转移病灶、接受化疗、未接受手术切除以及在西部（与东北部相比）接受治疗是生存不良的独立预测因素。我们发现不同区域间存在显著的生存差异，其中西部地区的生存情况最差，与东北部地区相比尤为明显。结论：除了已知的ACC远期死亡率预测因素（肿瘤位置、分期和治疗方式）外，我们的研究还发现，在多变量分析中，缺乏社会支持（未婚）和地理位置（西部地区）是远期死亡率的独立预测因素。需要进一步研究以探索其因果关系。
肿瘤(癌症)患者之家