Clinicopathological Review and Survival Characteristics of Adenoid Cystic Carcinoma

Abstract

To study the clinical characters, the outcomes of treatments and the factors affecting treatment results of adenoid cystic carcinomas at Shahid Sadoughi Hospital and Shahid Ramazanzadeh radiotherapy center, Yazd, Iran. The clinical data of 31 patients with adenoid cystic carcinoma of any anatomic site diagnosed over an 8 year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012), were investigated retrospectively. Data regarding patients' characteristics, pathological features and follow-up were obtained from patients records. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression. The study included31 patients with adenoid cystic carcinoma. The mean age at presentation was 50.2 ± 24.8 years. There were 11 (35.5 %) males and 20 (64.5 %) females with a female predilection (M:F = 0.55:1). Parotid gland was the most common site (8/31, 25.7 %) followed by submandibular gland (7/31, 22.6 %). Perineural invasion was detected in 67.7 % of the cases. Positive surgical status was reported in 48.4 % of the specimens. Metastasis was detected in 25.8 % of the patients and the most common site of distant metastasis was lung. Overall survival rates at 2, 5, and 7 years were 95, 75, and 57 % respectively. Margin status showed significant effect on survival (P value = 0.01). Positive surgical margin is an important factor affecting the prognosis of the patients with adenoid cystic carcinoma. Surgery with negative surgical margin is the first choice of treatment for the patients with adenoid cystic carcinoma. Our findings show that the prognosis of patients with adenoid cystic carcinoma in our center is fair.

Clinical outcomes and the role of bronchoscopic intervention in patients with primary pulmonary salivary gland-type tumors

“…Disease progression was related with ACC, larger tumor size, and non-surgical treatment. It seems that ACC often has a positive margin even after surgical resection, because of the submucosal spread and perineural invasion that commonly extends beyond the visible tumor [8,10,22,23]. Previous studies have shown that complete resection and radical mediastinal nodal resection did not have a positive effect on survival in patients with ACC [24,25].…”

Adenoid cystic carcinoma: A study of 19 cases of salivary and extra‐salivary tumours diagnosed by fine needle aspiration cytology

“…ACC is a slow‐growing tumour generally with an aggressive behaviour and a peak incidence in the fifth to seventh decades of life . Reaching a correct cytologic diagnosis is often fraught with difficulties perhaps due to the enormous variability in the fine needle aspirate findings.…”

Prognostic nomogram for adenoid cystic carcinoma in different anatomic sites

“…The preferred treatment for the majority of the patients is radical surgery with postoperative radiotherapy 6,8,9 . Due to the slow and persistent clinical course of ACC, patients may survive for years even after recurrence, and the overall survival rates at 2, 5 and 7 years have been reported to be 95%, 75% and 57%, respectively 10 . Many studies have focused on identifying specific prognostic factors for ACC, such as site of origin, tumor size, lymph nodes, distal metastases, clinical stage, solid histological pattern or histopathology grade, early or late diagnosis, the presence of affected surgical margins and macroscopic perineural invasion 11‐13 .…”