Moran Amit1,2, Yoav Binenbaum2, Kanika Sharma2, Naomi Ramer3, Ilana Ramer3, Abib Agbetoba4, Joelle Glick4, Xinjie Yang5, Delin Lei5, Kristine Bjørndal6, Christian Godballe6, Thomas Mücke7, Klaus-Dietrich Wolff7, Dan Fliss8, André M Eckardt9, Chiara Copelli10, Enrico Sesenna10, Frank Palmer11, Ian Ganly11, Snehal Patel11, Ziv Gil1,2,12. 1. Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Haifa, Israel. 2. The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam Rambam Medical Center, the Technion, Israel Institute of Technology, Israel. 3. Department of Radiotherapy and Oncology, Max Cancer Center, New Delhi, India. 4. Mount Sinai Medical Center, Department of Pathology, The Mount Sinai School of Medicine, New York, New York. 5. Department of Otolaryngology, The Mount Sinai School of Medicine, 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, Klinikum rechts der Isar, Technische Universität München, München, Germany. 9. Department of Otolaryngology Head and Neck Surgery, Tel Aviv Medical Center, Tel Aviv, Israel. 10. Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany. 11. Maxillo-Facial Surgery, University-Hospital of Parma, Italy. 12. Head and Neck Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Abstract
BACKGROUND: The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. METHODS: We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. RESULTS: The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival. CONCLUSION: Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity.
BACKGROUND: The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. METHODS: We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. RESULTS: The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival. CONCLUSION: Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity.
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