Moran Amit1, Yoav Binenbaum1, Leonor Trejo-Leider2, Kanika Sharma3, Naomi Ramer4, Ilana Ramer4, Abib Agbetoba5, Brett Miles5, Xinjie Yang6, Delin Lei6, Kristine Bjørndal7, Christian Godballe7, Thomas Mücke8, Klaus-Dietrich Wolff8, André M Eckardt9, Chiara Copelli10, Enrico Sesenna10, Frank Palmer11, Ian Ganly11, Snehal Patel11, Ziv Gil1,12. 1. The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam, Rambam Medical Center, Rappaport Medical School, The Technion, Israel Institute of Technology, Haifa, Israel. 2. Department of Pathology, Tel Aviv Medical Center, Tel Aviv, Israel. 3. Department of Radiotherapy and Oncology, Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India. 4. Department of Pathology, The Mount Sinai School of Medicine, New York, New York. 5. Department of Otolaryngology, Ichan School of Medicine at Mount Sinai, New York, New York. 6. Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, People's Republic of China. 7. Department of Otolaryngology Head and Neck Surgery, Odense University Hospital Odense, Denmark. 8. Department of Oral and Maxillofacial Surgery, Technische Universität München, München, Germany. 9. Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany. 10. Maxillo-Facial Surgery, University-Hospital of Parma, Italy. 11. Head and Neck Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York. 12. Department of Otolaryngology Head and Neck Surgery, Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel.
Abstract
BACKGROUND: The purpose of this study was to characterize the incidence, pattern of spread, and prognostic correlation of nerve invasion in patients with adenoid cystic carcinoma (ACC). METHODS: Using 3 different pathological categories of perineural invasion, intraneural invasion, and perineural inflammation, we investigated the prognostic value of nerve invasion in a total of 495 ACCs from 9 international patient cohorts with median follow-up 90 months (range, 12-288 months). RESULTS: Of 239 patients (48%) with nerve invasion, 174 (73%) had perineural invasion, 65 (27%) intraneural invasion, and 37 (15%) perineural inflammation. Multivariate Cox regression analysis identified tumor site (p = .008; hazard ratio [HR] = 1.8; 95% confidence interval [CI] = 0.07-3.7) and intraneural invasion (p < .001; HR = 5.9; 95% CI = 0.8-12.3) as independent prognostic markers for both overall survival (OS) and disease-specific survival (DSS), but not of distant metastases. CONCLUSION: Although perineural invasion has no impact on survival, intraneural invasion is an independent predictor of poor prognosis. Recognition of intraneural invasion may help optimize treatment of patients with head and neck ACC.
BACKGROUND: The purpose of this study was to characterize the incidence, pattern of spread, and prognostic correlation of nerve invasion in patients with adenoid cystic carcinoma (ACC). METHODS: Using 3 different pathological categories of perineural invasion, intraneural invasion, and perineural inflammation, we investigated the prognostic value of nerve invasion in a total of 495 ACCs from 9 international patient cohorts with median follow-up 90 months (range, 12-288 months). RESULTS: Of 239 patients (48%) with nerve invasion, 174 (73%) had perineural invasion, 65 (27%) intraneural invasion, and 37 (15%) perineural inflammation. Multivariate Cox regression analysis identified tumor site (p = .008; hazard ratio [HR] = 1.8; 95% confidence interval [CI] = 0.07-3.7) and intraneural invasion (p < .001; HR = 5.9; 95% CI = 0.8-12.3) as independent prognostic markers for both overall survival (OS) and disease-specific survival (DSS), but not of distant metastases. CONCLUSION: Although perineural invasion has no impact on survival, intraneural invasion is an independent predictor of poor prognosis. Recognition of intraneural invasion may help optimize treatment of patients with head and neck ACC.
Authors: Bin Xu; Esther Drill; Allen Ho; Alan Ho; Lara Dunn; Carlos Nicolas Prieto-Granada; Timothy Chan; Ian Ganly; Ronald Ghossein; Nora Katabi Journal: Am J Surg Pathol Date: 2017-10 Impact factor: 6.394
Authors: Moran Amit; Ayelet Eran; Salem Billan; Eran Fridman; Shorook Na'ara; Tomer Charas; Ziv Gil Journal: J Neurol Surg B Skull Base Date: 2016-02-26