Clinical Outcomes and Prognostic Factors of Adenoid Cystic Carcinoma of the Head and Neck

Anticancer Res. 2017 Jun;37(6):3045-3052. doi: 10.21873/anticanres.11659.

Abstract

Background: Adenoid cystic carcinoma (ACC) is a salivary gland malignancy with unpredictable growth and poorly understood prognostic factors.

Patients and methods: A database search of patients treated at a single Institution was used to identify patients with histologically-confirmed ACC. Patient, tumor, and treatment characteristics were examined via review of medical records.

Results: Overall survival of 70 patients identified at 5, 10, and 15 years was 80.4%, 61.3%, and 29.4%, respectively. Disease recurrence was seen in 31.9%; of these, 72.7% developed distant metastasis. Older age, higher stage, skull base involvement, positive margins, and metastatic disease, but not local recurrence, predicted a worse overall survival. Higher stage and skull base disease were also associated with shorter disease-free survival. While lung metastasis was the most common, vertebral metastasis was associated with poorer survival.

Conclusion: Disease stage, positive margins, skull base involvement, perineural invasion, time to recurrence, and location of metastasis, but not nodal involvement, could serve as poor prognostic factors in ACC.

Keywords: Adenoid cystic carcinoma; head and neck cancer; metastasis; prognosis; salivary gland tumor.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma, Adenoid Cystic / pathology*
  • Carcinoma, Adenoid Cystic / radiotherapy
  • Child
  • Female
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy, Adjuvant
  • Treatment Outcome
  • Young Adult