BACKGROUND: Adenoid cystic carcinoma is a rare salivary gland malignancy with a poor disease free survival due to frequent distant metastases and late local recurrences. Previous single-center reports on outcome mostly encompass small series. In this report a relative large series of 105 cases is analyzed, all treated at the VU University Medical Center, Amsterdam, The Netherlands over a 30-year period in which treatment strategies remained unchanged. METHODS: All cases of ACC of the head and neck between 1979 and 2009 at our institution were analyzed through a medical chart review. Recurrence patterns and possible prognostic factors (T-stage, N-status, age, gender, type of salivary gland involved, histological grade, surgical margins, perineural invasion (PNI) and postoperative radiotherapy (RT)) were analyzed. RESULTS: One-hundred and five cases of ACC of the head and neck were identified. Five-, ten- and twenty-year survival rates for overall survival were 68%, 52% and 28%, respectively. T-stage, N-status, surgical margins, histological subtype and age were highly significant predictors for survival. PNI was not a negative prognosticator. CONCLUSIONS: T-stage, N-status, surgical margins, histological grade and age are the main predictors of survival-outcome in ACC of the head and neck. Distant metastasis frequently develop, mainly in the first 5 years post treatment. Local recurrences often develop even later on, warranting long term follow up of patients treated for ACC. Grade III ACC should be considered a specific entity within the group of ACC due to its typical aggressive biological behavior and relatively poor outcome, implicating the need for an improved adjuvant treatment.
BACKGROUND:Adenoid cystic carcinoma is a rare salivary gland malignancy with a poor disease free survival due to frequent distant metastases and late local recurrences. Previous single-center reports on outcome mostly encompass small series. In this report a relative large series of 105 cases is analyzed, all treated at the VU University Medical Center, Amsterdam, The Netherlands over a 30-year period in which treatment strategies remained unchanged. METHODS: All cases of ACC of the head and neck between 1979 and 2009 at our institution were analyzed through a medical chart review. Recurrence patterns and possible prognostic factors (T-stage, N-status, age, gender, type of salivary gland involved, histological grade, surgical margins, perineural invasion (PNI) and postoperative radiotherapy (RT)) were analyzed. RESULTS: One-hundred and five cases of ACC of the head and neck were identified. Five-, ten- and twenty-year survival rates for overall survival were 68%, 52% and 28%, respectively. T-stage, N-status, surgical margins, histological subtype and age were highly significant predictors for survival. PNI was not a negative prognosticator. CONCLUSIONS: T-stage, N-status, surgical margins, histological grade and age are the main predictors of survival-outcome in ACC of the head and neck. Distant metastasis frequently develop, mainly in the first 5 years post treatment. Local recurrences often develop even later on, warranting long term follow up of patients treated for ACC. Grade III ACC should be considered a specific entity within the group of ACC due to its typical aggressive biological behavior and relatively poor outcome, implicating the need for an improved adjuvant treatment.
Authors: Christopher C Griffith; Reetesh K Pai; Frank Schneider; Umamaheswar Duvvuri; Robert L Ferris; Jonas T Johnson; Raja R Seethala Journal: Am J Clin Pathol Date: 2015-06 Impact factor: 2.493
Authors: Carlos Suárez; Robert P Takes; Carl E Silver; Juan P Rodrigo; Primož Strojan; Julia A Woolgar; Missak Haigentz; H Hakan Coskun; Remco de Bree; Randall P Owen; Mohamed N Elsheikh; Ashok R Shaha; Alessandra Rinaldo; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2014-02-04 Impact factor: 2.503
Authors: Carlos Suárez; Leon Barnes; Carl E Silver; Juan P Rodrigo; Jatin P Shah; Asterios Triantafyllou; Alessandra Rinaldo; Antonio Cardesa; Karen T Pitman; Luiz P Kowalski; K Thomas Robbins; Henrik Hellquist; Jesus E Medina; Remco de Bree; Robert P Takes; Andrés Coca-Pelaz; Patrick J Bradley; Douglas R Gnepp; Afshin Teymoortash; Primož Strojan; William M Mendenhall; Jean Anderson Eloy; Justin A Bishop; Kenneth O Devaney; Lester D R Thompson; Marc Hamoir; Pieter J Slootweg; Vincent Vander Poorten; Michelle D Williams; Bruce M Wenig; Alena Skálová; Alfio Ferlito Journal: Auris Nasus Larynx Date: 2016-03-24 Impact factor: 1.863
Authors: Safina Ali; Frank L Palmer; Nora Katabi; Nancy Lee; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Laryngoscope Date: 2017-03-21 Impact factor: 3.325