International collaborative validation of intraneural invasion as a prognostic marker in adenoid cystic carcinoma of the head and neck

Amit, Moran; Binenbaum, Yoav; Trejo-Leider, Leonor; Sharma, Kanika; Ramer, Naomi; Ramer, Ilana; Agbetoba, Abib; Miles, Brett A.; Yang, Xinjie; Lei, Delin; Bjørndal, Kristine; Godballe, Christian; Mücke, Thomas; Wolff, Klaus; Eckardt, A.; Copelli, Chiara; Sesenna, Enrico; Palmer, Frank L.; Ganly, Ian; Patel, Snehal G.; Gil, Ziv

doi:10.1002/hed.23710

Cited by 89 publications

(58 citation statements)

References 33 publications

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“…In our series, a clear margin was obtained in 68.1% of patients, and this population also showed a better OS rate but not an MFS rate than those with positive margin in both univariate and multivariate analysis, confirming the findings of previous studies (Amit et al, 2014a;Amit et al, 2014b;Choi et al, 2013;Amit et al, 2014c). However, the question remains as to how positive margin affects the survival rate of ACC.…”

Section: Discussionsupporting

confidence: 91%

Higher positive lymph node ratio indicates poorer distant metastasis–free survival in adenoid cystic carcinoma patients with nodal involvement

Liu

Fang

Dai

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Section: Discussionsupporting

confidence: 91%

Higher positive lymph node ratio indicates poorer distant metastasis–free survival in adenoid cystic carcinoma patients with nodal involvement

Liu

Fang

Dai

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…Perineural invasion is notoriously common in ACC, being reported in 29 to 63% of cases (6, 13, 17, 18, 35), and in 88% in our cohort. However, with the exception of one study showing an association of PNI with the extent of local disease and local recurrence, multiple previous studies have failed to reveal a significant association between perineural invasion and clinical outcomes, e.g.…”

Section: Discussionmentioning

confidence: 44%

“…However, with the exception of one study showing an association of PNI with the extent of local disease and local recurrence, multiple previous studies have failed to reveal a significant association between perineural invasion and clinical outcomes, e.g. OS, DSS, regional or distant metastasis (6, 13, 17, 18, 35). Similarly, in our cohort, the presence of PNI did not predict OS, DSS, nodal and distant metastasis in ACC.…”

Section: Discussionmentioning

confidence: 94%

“…The most consistent independent predictors repeatedly identified in these studies appeared to be AJCC TNM staging and margin status (3, 5, 14–16, 18). Additional independent adverse prognostic factors reported in a single multivariate study include female gender, older age, sinonasal or paranasal sinus location, solid pattern, LVI, and intraneural invasion (3, 14–17). Similar to prior studies, we found TNM staging to be an independent predictor for RFS.…”

Section: Discussionmentioning

confidence: 97%

“…Clinically, the tumor is characterized by a propensity for perineural spread, relentless slow growth, high frequency of local and distal recurrence as well as poor long term survival (1, 5, 9, 11–15, 17, 18). …”

Section: Discussionmentioning

confidence: 99%

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Predictors of Outcome in Adenoid Cystic Carcinoma of Salivary Glands

Xu¹,

Drill

et al. 2017

American Journal of Surgical Pathology

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Adenoid cystic carcinoma (ACC) is the second most common salivary gland malignancy and it has a high rate of recurrences and a poor long term prognosis. Our aim was to assess the prognostic factors in ACC and study MYB-NFIB fusion and MYB protein expression in a large retrospective cohort of 135 patients with a median follow up of 6.3 years. The 5-year and 10-year local recurrence-free survival rate of 94% and 78%, 5-year and 10-year distant metastasis survival rate of 77% and 58%, and 5-year and 10-year recurrence free survival (RFS) of 66% and 44%. The following features were identified as adverse prognostic factors of RFS on univariate analysis: large tumor size, solid growth pattern, increased mitoses, positive margin, AJCC clinical staging, high grade transformation, vascular invasion, nuclear atypia, open chromatin, prominent nucleoli, and tumor necrosis. However, on multivariate analysis, only increased mitoses (≥5/10 high power fields), any solid growth pattern, and advanced AJCC TNM staging were independent adverse predictors for RFS. MYB immuno-expression and MYB-NFIB translocation were common findings in ACC, occurring in 72% and 59% of the tested ACCs, respectively. The sensitivity and specificity of MYB immunohistochemistry in detecting MYB-NFIB fusion was relatively low at 78% sensitivity and 50% specificity. The high prevalence of alterations leading to high expression of the MYB transcription factor family suggests that targeted approaches developed to suppress the expression of these oncogenic transcription factors and/or the transcriptional activity of these proteins would be a rational therapeutic approach to investigate in ACC.

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Primary Tumor Staging for Oral Cancer and a Proposed Modification Incorporating Perineural Invasion: An International Multicenter Study

Subramaniam

Deganello

et al. 2023

Advanced Biology

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The objective of this study is to determine if the incorporation of perineural invasion (PNI) into the T‐classification would improve the prognostic performance of TNM‐8. An international, multicenter study of 1049 patients with oral cavity squamous cell carcinoma that were treated from 1994 to 2018 is performed. Various classification models are developed within each T‐category and evaluated using the Harrel‐concordance index (C‐index), Akaike‐information criterion (AIC), and visual inspection. Stratification into distinct prognostic categories, with internal validation, is performed using bootstrapping analysis (SPSS and R‐software). Through multivariate analysis, PNI is significantly associated with disease‐specific survival (p < 0.001). PNI integration into the staging system results in a significantly improved model compared with the current T category alone (lower AIC, p < 0.001). The PNI‐integrated model is superior in predicting differential outcomes between T3 and T4 patients. A new model for T‐classification of oral cavity squamous cell carcinoma is proposed, which is based on incorporating PNI into the staging system. These data can be used for future evaluations of the TNM staging system.

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International collaborative validation of intraneural invasion as a prognostic marker in adenoid cystic carcinoma of the head and neck

Abstract: 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.

Cited by 89 publications

References 33 publications

Higher positive lymph node ratio indicates poorer distant metastasis–free survival in adenoid cystic carcinoma patients with nodal involvement

Higher positive lymph node ratio indicates poorer distant metastasis–free survival in adenoid cystic carcinoma patients with nodal involvement

Predictors of Outcome in Adenoid Cystic Carcinoma of Salivary Glands

Primary Tumor Staging for Oral Cancer and a Proposed Modification Incorporating Perineural Invasion: An International Multicenter Study

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