Clinicopathologic predictors of recurrence and overall survival in adenoid cystic carcinoma of the head and neck: A single institutional experience at a tertiary care center

Marcinow, Anna M.; Özer, Enver; Teknos, Theodoros N.; Wei, Lai; Hurtuk, Agnes; Old, Matthew; Agrawal, Amit; Carrau, Ricardo L.; Iwenofu, O. Hans

doi:10.1002/hed.23523

Cited by 46 publications

(51 citation statements)

References 30 publications

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“…In the present study, advanced age (that is >60 years) did not affect dfs, implying that age alone does not modify the natural history of acc. The parotid and other salivary glands, followed by the oro-nasopharyngeal spaces, were the most common sites of origin, consistent with the literature 11,28,29 .…”

Section: Discussionsupporting

confidence: 88%

“…Female sex did not affect survival in our cohort. The data related to female sex as a prognostic factor are conflicting: A study based on the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results database suggested improved os; another study showed a worse dfs, even after matching for stage 2,28 . Although hormones or other sex-dependent biologic factors might explain a greater female:male ratio, whether the same factors affect disease behaviour or outcomes is unknown.…”

Section: Discussionmentioning

confidence: 99%

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Adenoid Cystic Carcinoma of Head and Neck: Clinical Predictors of Outcome from a Canadian Centre

Siever

Hao

et al. 2016

Current Oncology

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Objectives Adenoid cystic carcinoma (acc) is often treated with surgery, with or without adjuvant radiation therapy (rt). We evaluated disease characteristics, treatments, and potentially prognostic variables in patients with acc.Methods Our retrospective analysis considered consecutive cases of acc presenting at a tertiary care hospital between 2000 and 2014. Factors predictive of overall survival (os) and disease-free survival (dfs) were identified by univariate analysis. ResultsThe 60 patients analyzed had a mean age of 58 years (range: 22-88 years), with a 2:1 female:male ratio. Tumour locations included the major salivary glands (40% parotid, 17% submandibular and sublingual), the oro-nasopharyngeal cavity (27%), and other locations (16%). Of the 60 patients, 35 (58%) received surgery with adjuvant rt; 12 (20%), rt only; 13 (22%), surgery only. Of 18 patients (30%) who experienced a recurrence within 5 years, 3 (5%) developed local recurrence only, and the remaining 15 (25%), distant metastasis. The 5-year os and dfs were 64.5% [95% confidence interval (ci): 45.9% to 78.1%] and 46.2% (95% ci: 29.7% to 61.2%) respectively. In patients without recurrence, 5-year os was 77% (95% ci: 52.8% to 89.9%), and in patients with recurrence, it was 42.7% (95% ci: 15.8% to 67.6%). Patients treated with rt only had a 5-year os of 9.2%. Predictors of 5-year dfs were TNM stage, T stage, nodal status, treatment received, and margin status; age, nodal status, treatment received, and margin status predicted 5-year os.Conclusions Despite surgery and rt, one third of patients with acc experience distant recurrence. Patients whose tumours are not amenable to surgery have a poor prognosis, indicating a need for alternative approaches to improve outcomes.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Adenoid Cystic Carcinoma of Head and Neck: Clinical Predictors of Outcome from a Canadian Centre

Siever

Hao

et al. 2016

Current Oncology

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“…The known predilection of ACC for perineural invasion, and the association of PNI with disease recurrence,(2, 3) adds importance to our finding that the axonal guidance signaling pathway is significantly altered in ACC. Somatic mutations of genes involved in axonal guidance signaling (including NTNG1, SEMA3G, and SEMA5A ) were also previously noted by Ho et al ,(5) and an identical SEMA3G non-synonymous substitution (474S>P) was observed in our cohort.…”

Section: Discussionmentioning

confidence: 61%

“…(1) ACC frequently spreads to nearby nerves, a process termed perineural invasion (PNI), which portends poor prognosis and higher likelihood of local recurrence. (2, 3) There are at present no reliable chemotherapeutic options for long-term disease control.…”

Section: Introductionmentioning

confidence: 99%

Whole-Genome Sequencing of Salivary Gland Adenoid Cystic Carcinoma

Rettig

Talbot

Sausen

et al. 2016

Cancer Prevention Research

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Adenoid cystic carcinomas (ACCs) of the salivary glands are challenging to understand, treat, and cure. To better understand the genetic alterations underlying the pathogenesis of these tumors, we performed comprehensive genome analyses of 25 fresh-frozen tumors, including whole genome sequencing, expression and pathway analyses. In addition to the well-described MYB-NFIB fusion which was found in 11 tumors (44%), we observed five different rearrangements involving the NFIB transcription factor gene in seven tumors (28%). Taken together, NFIB translocations occurred in 15 of 25 samples (60%, 95%CI=41–77%). In addition, mRNA expression analysis of 17 tumors revealed overexpression of NFIB in ACC tumors compared with normal tissues (p=0.002). There was no difference in NFIB mRNA expression in tumors with NFIB fusions compared to those without. We also report somatic mutations of genes involved in the axonal guidance and Rho family signaling pathways. Finally, we confirm previously described alterations in genes related to chromatin regulation and Notch signaling. Our findings suggest a separate role for NFIB in ACC oncogenesis and highlight important signaling pathways for future functional characterization and potential therapeutic targeting.

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“…Nevertheless, gender does not represent a factor of prognostic significance for survival [1,8] ( Table 3). Although cribriform and solid histologic subtypes are the most frequently identified patterns in this and other studies' their significance as prognostic factors does not enjoy a widely spread consensus [9]. Nevertheless, a multivariate analysis performed by Da Cruz Perez et al [1], found that solid type was a significant prognostic factor and, similarly, Van Weert et al [10] confirmed that the solid type or Grade III is related to a significantly worse outcome, possibly because it is a higher grade tumor with a more aggressive growth pattern and a tendency for early development of distant metastasis.…”

Section: Discussionmentioning

confidence: 64%

Adenoid Cystic Carcinoma in a Mexican Population

Luna-Ortiz¹,

Villavicencio-Valencia²,

Rodriguez-Falconi³

et al. 2015

J. Maxillofac. Oral Surg.

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Objective To analyze the demographic data, clinical behavior, management (surgery/radiotherapy), disease-free survival (DFS) and overall survival (OS) in Mexican Mestizos with adenoid cystic carcinoma (ACC).Material and Methods A retrospective study comprising all cases with histologic diagnosis of ACC of the head and neck treated from 1986 to 2012. Results There were 101 cases (69 women and 32 men), with a mean age of 50 years; mean evolution time before diagnosis was 25 months (range 1-180 months). Most tumors involved maxillary sinus (25.8 %), followed by hard palate (15.9 %) and parotid gland (10.9 %). Surgery was the treatment in 81 cases (80.2 %), radiotherapy alone in 3 cases (3 %), chemo-radiotherapy in 4 cases (4 %) and 13 cases (12.9 %) did not receive any treatment. Postsurgery adjuvant radiotherapy was used in 58 cases (57.4 %); 6 cases (5.9 %) had adjuvant chemo-radiotherapy after surgery and 37 (36.6 %) cases did not receive any adjuvant treatment. Mean follow-up time was 52 months (range 1-288 months). Histologic patterns were cribriform (50.5 %), solid (28.7 %), and tubular (11.9 %) types. OS was 57.6 % and 42.3 % at 5 and 10 years respectively. DFS was 57.8 % at 5 years and 49.7 % at 10 years. Conclusions Initial management in most cases within this series was surgery followed by radiotherapy. There is more to learn about real benefits of molecular therapies. There were no significant differences in DFS and OS depending on site of involvement. OS did not show statistically significant differences amongst patients with positive and negative lymph nodes.

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Clinicopathologic predictors of recurrence and overall survival in adenoid cystic carcinoma of the head and neck: A single institutional experience at a tertiary care center

Cited by 46 publications

References 30 publications

Adenoid Cystic Carcinoma of Head and Neck: Clinical Predictors of Outcome from a Canadian Centre

Adenoid Cystic Carcinoma of Head and Neck: Clinical Predictors of Outcome from a Canadian Centre

Whole-Genome Sequencing of Salivary Gland Adenoid Cystic Carcinoma

Adenoid Cystic Carcinoma in a Mexican Population

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