BACKGROUND Distant metastases (DMs) are the primary cause of treatment failure in patients with salivary gland carcinoma. There is no consensus on the standard treatment. METHODS Patients with DMs were identified from an institutional database of 884 patients with salivary gland cancer who underwent resection of the primary tumor between 1985 and 2015. Survival outcomes for patients with DMs were determined with the Kaplan-Meier method. Univariate and multivariate analyses were performed to identify factors associated with DM. RESULTS Of the 884 patients identified, 137 (15%) developed DMs during follow-up. Most of the primary tumors (n = 77 [56%]) were located in a major salivary gland. At clinical presentation, 53% of the tumors were classified as T3 or T4, and 32% had clinical node metastases. The median time to DM was 20.3 months. The factors associated with shorter distant recurrence-free survival were male sex, high-risk tumor histology, and advanced pathological T and N classifications. Patients with bone metastases had a lower survival rate than patients with lung metastases. The total number of DMs in a patient was inversely associated with survival. Patients who underwent surgical resection of DMs had a significantly higher 5-year rate of metastatic disease-specific survival than patients who underwent observation or nonsurgical treatment (44%, 29%, and 19%, respectively; P = .003). CONCLUSIONS In patients with DMs of salivary gland carcinoma, survival is negatively associated with high-grade histology, bone DMs, and the total number of DMs. Metastasectomy can help to lengthen disease-free survival.

中文翻译：

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唾液腺癌的远处转移：发生率，处理和结果。

背景技术远处转移（DM）是唾液腺癌患者治疗失败的主要原因。关于标准治疗尚无共识。方法从1985年至2015年间接受原发肿瘤切除的884例涎腺癌患者的机构数据库中鉴定出DM患者。采用Kaplan-Meier方法确定DM患者的生存结果。进行单变量和多变量分析以鉴定与DM相关的因素。结果在确定的884例患者中，有137例（15％）在随访期间发生了DM。大多数原发肿瘤（n = 77 [56％]）位于主要的唾液腺中。在临床表现中，有53％的肿瘤被分类为T3或T4，而32％的肿瘤则有临床淋巴结转移。DM的中位时间为20.3个月。远距离无复发生存期较短的相关因素是男性，高危肿瘤组织学以及病理性T和N分类。骨转移患者的生存率低于肺转移患者。患者中DM的总数与存活成反比。与接受观察或非手术治疗的患者相比，接受DM手术切除的患者的5年转移性疾病特异性生存率明显更高（分别为44％，29％和19％； P = 0.003）。结论涎腺癌DM患者的生存率与高级组织学，骨DM和DM总数呈负相关。转移瘤切除术可以帮助延长无病生存期。