Original Article
Clinical outcome of head and neck adenoid cystic carcinoma in the Taiwan population: a single institution experience
Abstract
Background: Adenoid cystic carcinoma (ACC) is a rare malignant cell type in the head and neck region. Although most ACC are classified as low grade, clinical course and outcome may be very different depending on the tumor site. We aim to evaluate the clinical pattern and prognosis in our institution.
Methods: Patients with head and neck ACC (HNACC) without distant metastasis at diagnosis and received curative-intent management at our institution were identified. Clinicopathologic features were collected and outcomes were analyzed. We used the Kaplan-Meier statistic method to estimate local control, disease-free survival (DFS) and overall survival (OS) in these patients.
Results: In this retrospective study, we reviewed 53 patients who were diagnosed with HNACC between January 1995 and December 2014 in our institution. The mean patient age was 52.66 years (range, 23–92 years) and median follow-up time was 5.65 years (range, 1.89–19.48 years). Tumors originated from the salivary gland in 33 patients and from other sites in 20 patients. Fourteen locoregional recurrences and 17 distant metastatic events were noted. Between the salivary gland and non-salivary gland group, 5-year OS were 90.4% and 71.4% (P=0.248) respectively, and 5-year locoregional recurrence-free survival rates were 90.8% and 47.1% (P=0.002) respectively. In multivariate analysis, female gender, non-salivary gland site, nodal positive, close/positive margin, and adjuvant radiotherapy showed significant influence for locoregional recurrence-free survival.
Conclusions: Non-salivary gland ACC had worse locoregional recurrence-free survival and radiotherapy showed benefit towards locoregional control. The most common failure was distant metastasis, especially to the lungs. Further research for systemic therapy is warranted.
Methods: Patients with head and neck ACC (HNACC) without distant metastasis at diagnosis and received curative-intent management at our institution were identified. Clinicopathologic features were collected and outcomes were analyzed. We used the Kaplan-Meier statistic method to estimate local control, disease-free survival (DFS) and overall survival (OS) in these patients.
Results: In this retrospective study, we reviewed 53 patients who were diagnosed with HNACC between January 1995 and December 2014 in our institution. The mean patient age was 52.66 years (range, 23–92 years) and median follow-up time was 5.65 years (range, 1.89–19.48 years). Tumors originated from the salivary gland in 33 patients and from other sites in 20 patients. Fourteen locoregional recurrences and 17 distant metastatic events were noted. Between the salivary gland and non-salivary gland group, 5-year OS were 90.4% and 71.4% (P=0.248) respectively, and 5-year locoregional recurrence-free survival rates were 90.8% and 47.1% (P=0.002) respectively. In multivariate analysis, female gender, non-salivary gland site, nodal positive, close/positive margin, and adjuvant radiotherapy showed significant influence for locoregional recurrence-free survival.
Conclusions: Non-salivary gland ACC had worse locoregional recurrence-free survival and radiotherapy showed benefit towards locoregional control. The most common failure was distant metastasis, especially to the lungs. Further research for systemic therapy is warranted.
