Prognostički čimbenici primarnih tumora submandibularne žlijezde

master's thesis

• Title (english): Prognostic factors of primary submandibular gland tumors
• Author: Matija Mamić
• Mentor: Ivica Lukšić (mentor)
• Committee member: Mihajlo Virag (predsjednik povjerenstva)
• Committee member: Drago Prgomet (član povjerenstva)
• Committee member: Ivica Lukšić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Maxillofacial Surgery and Dentistry); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Tumori submandibulare žlijezde su vrlo rijetke neoplazme. Njihova posebnost je što obuhvaćaju široki raspon kako benignih, tako i malignih podtipova. Ciljevi ovog rada bili su utvrditi učestalost pojedinih histoloških podtipova tumora, njihovu distribuciju vezanu za spol i dob oboljelih, te pokušati odrediti povezanost između čimbenika rizika i stope preživljenja, te evaluirati opseg kirurškog zahvata u liječenju tumora submandibularne žlijezde. U ovaj rad uključeno je 60 pacijenta sa tumorom submandibularne žlijezde koji su se liječili u Klinici za kirurgiju lica, čeljusti i usta, Kliničke bolnice Dubrava, u vremenskom periodu od 1985. do 2013. godine. Povijesti bolesti uključenih bolesnika detaljno su pregledane, a potrebni podaci su uvršteni u tablice iz kojih je slijedila statistička obrada. Među uključenim bolesnicima bio je 31 benigan i 29 maligni tumor. Prosječna dob pacijenta oboljelih od benignih tumora submandibularne žlijezde bila je 43 godine, dok je kod malignih tumora ta dob iznosila 60 godina. Omjer muškaraca naspram žena kod benignih tipova bio je 1:2, dok je kod malignih tipova taj omjer bio obratan, 2:1. Najučestaliji histološki podtip među benignim tumorima bio je pleomorfni adenom, dok je kod malignih tumora najučestaliji podtip bio adenoidni cistični karcinom. Kao čimbenik koji je značajan za lošije preživljenje bolesnika definirana je starija životna dob (>65 godina). Kao statistički značajan čimbenik koji je utjecao na povoljan ishod petogodišnjeg preživljenja kod malignih tipova pokazala se postoperativna radioterapija (p=0.043). Prema rezultatima ovoga rada, metoda izbora za liječenje benignih tumora je ekstirpacija submandibularne žlijezde s tumorom, dok se za maligne tumore preporuča prošireni zahvat koji uz odstranjenje žlijezde obuhvaća i selektivnu disekciju vrata. Ovaj rad bi trebao pridonijeti boljem razumijevanju tumora žlijezda slinovnica i biti koristan u definiranju optimalnog kirurškog zahvata kod oboljelih od primarnog tumora submandibularne žlijezde.

Abstract (english)

Tumors of submandibular gland are very rare neoplasms. Their uniqueness is in including a wide range of both benign and malignant subtypes. The objectives of this study were to determine the frequency of certain histological subtypes of tumours and their distribution in relation to age and sex of patients, to try to find the association between risk factors and survival rate, and to evaluate the extent of surgical procedure in treatment of submandibular gland tumours. This paper included 60 patients with primary tumours of submandibular gland, surgically treated from 1985 to 2013, in the Clinic of Maxillofacial and Oral Surgery Dubrava, University Hospital. The medical records from included patients were reviewed, and from the needed data enclosed in tables followed the statistical analysis. Among involved patients were 31 benign and 29 malignant submandibular gland tumours. The average age of patients suffered from benign tumours was 43 years and of malignant tumours was 60 years. The ratio between male and female in benign types was 1:2, while in malignant types male and female ratio was 2:1. In benign tumours the most common subtype was adenoma pleomorphe, while in malignant tumours the most common subtype was adenoid cystic carcinoma. Old age (>65 years) was defined as a predictor of poor survival of patients, and postoperative radiotherapy was statistically significant factor affecting the five-year overall survival in malignant subtypes (p=0.043). According to the results of this study, the method of choice for the treatment of benign tumours is the extirpation of the tumour infiltrated submandibular gland, while in malignant tumours, the extended procedure of removing of the gland that includes a selective neck dissection is recommended. This paper should contribute to better understanding of salivary gland tumours, and be useful to define the optimal surgical treatment in patients with primary tumour of submandibular gland.

• Keywords: submandibularna žlijezda; tumor žlijezda slinovnica; kirurško liječenje; prognostički čimbenici
• Keywords (english): submandibular gland; salivary tumour; surgical treatment; prognostic factor
• Language: croatian
• URN:NBN: urn:nbn:hr:105:921838
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-09 08:30:14