Risk factors and prognosis for salivary gland adenoid cystic carcinoma in southern china

Abstract

Adenoid cystic carcinoma (ACC) is characterized by slow growth, frequent local recurrences, and high incidence of distant metastasis (DM). The aim of this study was to evaluate predictive factors for local-regional (LR) recurrence, DM, and survival in ACC.A retrospective review of the medical records for patients with salivary glands ACC from 1990 to 2015 was performed. The clinical parameters were assessed to identify correlations with the development of LR recurrence, DM, and survival of these patients.Among 228 patients who underwent surgery as definitive treatment, 210 (92.1%) were followed up in the study. DM was detected in 64 (30.5%) patients, LR recurrence was detected in 58 (27.6%) patients. The estimated 5, 10, and 15-year overall survival rates were 84.7%, 70.8%, and 34.0%, respectively. Multivariate analysis revealed that the presence of lymphovascular invasion and a high T classification were very strong adverse factors, which independently influenced LR recurrence, DM, and survival of ACC patients. Positive/close margin and N+ status were independent risk factors for DM and LR recurrence, respectively. Survival of ACC patents was also affected by tumor location.Presence of lymphovascular invasion and a high T classification were very strong adverse factors and independent predictors for ACC patients’ prognosis, which influenced LR control, DM control, and survival.

Disparities in Postoperative Therapy for Salivary Gland Adenoid Cystic Carcinomas

“…Adenoid cystic carcinomas (ACC) represent approximately 10% of salivary gland tumors and less than 1% of all head and neck tumors . Given its rarity, the optimal management of nonmetastatic ACC has been influenced by retrospective reviews from large centers rather than randomized trials . ACC grow relatively slowly compared to other head and neck cancers, have lower risk of lymph node metastases, and have high propensity for perineural invasion .…”

“…Chemotherapy has been investigated, but low response rates have been disappointing . The standard therapy for localized disease is surgical resection followed by adjuvant radiotherapy …”

“…[1][2][3] Given its rarity, the optimal management of nonmetastatic ACC has been influenced by retrospective reviews from large centers rather than randomized trials. [4][5][6][7] ACC grow relatively slowly compared to other head and neck cancers, have lower risk of lymph node metastases, and have high propensity for perineural invasion. 3,7,8 ACC have a tendency for hematogenous spread at early stages, mostly to the lungs, liver, and bones.…”

“…9 The standard therapy for localized disease is surgical resection followed by adjuvant radiotherapy. [5][6][7]10,11 Current National Comprehensive Cancer Network (NCCN) guidelines state that postoperative radiotherapy should be "considered" for completely resected ACC and is recommended for patients with positive margins. 12 Given the lack of clarity in national guidelines for postoperative radiation, the low prevalence of the disease, and to further understand practice patterns of adjuvant therapy in the United States (U.S.), we used the National Cancer Data Base (NCDB) to identify a large cohort of patients with nonmetastatic salivary gland ACC who underwent definitive primary surgical resection.…”

Regulation of β-Catenin Phosphorylation by PR55β in Adenoid Cystic Carcinoma

“…To date, many clinical AdCC studies have reported that poor prognosis is associated with pathological features such as AdCC type and grade (4). Histological specimens can be divided into three groups: tubular, cribriform, or solid.…”