Treatment outcomes and prognostic features in adenoid cystic carcinoma originated from the head and neck

Shen, Chunying; Xu, Tianmin; Huang, Chenlu; Hu, Chaosu; He, Shasha

doi:10.1016/j.oraloncology.2011.12.002

Cited by 74 publications

(96 citation statements)

References 21 publications

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“…Almost one third of our patients developed distant metastasis; only 15% of the recurrences were locoregional. Those findings contrast with results published by other authors who have reported locoregional recurrences in 30%-50% of all patients with recurrence 11,17,26,30 . Without recurrence, the 5-year os in our cohort was 77%; with recurrence, it was 43%, indicating that, although recurrence is associated with mortality, the disease is not rapidly fatal.…”

Section: Discussioncontrasting

confidence: 98%

“…One third of the patients studied by Fordice et al experienced a recurrence, but at least one third of the recurrences were locoregional; of our patients, more than 85% experienced their recurrence as distant metastasis. In contrast, Monteiro et al 30 reported that 60% of their patients received both surgery and rt, and 11% received rt alone; 5-year os in their cohort was 68%, similar to that in our cohort.…”

Section: Discussionsupporting

confidence: 83%

“…Based on similar small retrospective studies, the U.S. National Comprehensive Cancer Network guideline 34 suggests that adjuvant rt should be offered to patients with risk factors for recurrence such as high grade, positive margins, perineural invasion, lymph node metastasis, and lymphovascular invasion (evidence category 2B). However, adjuvant rt is associated with improved locoregional control or dfs, but not with os when patients are matched for stage 30,32,33 . In addition, patients treated with rt alone in our study had a poor 5-year os of 9.2%.…”

Section: Discussionmentioning

confidence: 97%

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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: Discussioncontrasting

confidence: 98%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 97%

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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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“…Postoperative radiation therapy for ACC was usually performed in most institutions. Recent studies 36,37 have indicated that surgery combined with postoperative treatment could achieve better local control and improve disease-free survival. However, the role of chemotherapy in ACC is controversial and no definitive protocols have become universally accepted.…”

mentioning

confidence: 99%

High Expression of H3K9me3 Is a Strong Predictor of Poor Survival in Patients With Salivary Adenoid Cystic Carcinoma

Xia

Zhou

Tian

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Histone methylation and acetylation play important roles in the carcinogenesis and progression of cancer. Objective.—To investigate whether histone modifications influence the prognosis of patients with salivary adenoid cystic carcinoma (ACC). Design.—The expression of histone H3 lysine 9 trimethylation (H3K9me3) and histone H3 lysine 9 acetylation (H3K9Ac) was assessed by immunohistochemistry in 66 specimens of primary ACC. Tests were used to determine the presence of any correlation between H3K9me3 and H3K9Ac levels and clinicopathologic parameters. Log-rank test and Cox proportional hazards regression models were used to analyze the survival data. Results.—H3K9me3 expression was positively correlated with solid pattern tumors (P = .002) and distant metastasis (P = .001). Solid pattern tumors had lower H3K9Ac expression levels than cribriform-tubular pattern tumors (P = .03). Patients whose tumors showed high H3K9me3 expression and a solid pattern had a significantly poorer overall survival (OS) (P < .001 and P < .001, respectively) and disease-free survival (P < .001 and P = .01, respectively). Low H3K9Ac expression was correlated with poor OS (P = .05). The multivariate analysis indicated that high levels of H3K9me3 expression and solid pattern tumors were independent prognostic factors that significantly influenced OS (P = .004 and P = .04, respectively). H3K9me3 expression was identified as the only independent predictor of disease-free survival (P = .006). Conclusions.—Our results suggest that high levels of H3K9me3 expression are predictive of rapid cell proliferation and distant metastasis in ACC. Compared with histologic patterns, H3K9me3 might be a better predictive biomarker for the prognosis of patients with salivary ACC.

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“…Therefore, timely diagnosis and treatment are essential in ACC cases. Although no definitive clinical approach for preventing distant metastasis has been established, it was previously reported that surgery with postoperative radiotherapy significantly improved the outcomes (13). Additionally, Lin et al (14) reported that postoperative radiotherapy reduced the recurrence rate in patients with a negative resection margin.…”

Section: Discussionmentioning

confidence: 99%

Controlling distant metastasis and surgical treatment are crucial for improving clinical outcome in uncommon head and neck malignancies, such as non-squamous cell carcinoma

Shiiba

Unozawa

Higo

et al. 2014

Molecular and Clinical Oncology

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Abstract. The objective of this study was to elucidate the clinical characteristics of uncommon head and neck malignancies, such as non-squamous cell carcinoma (SCC), in order to improve patient outcomes. A total of 463 head and neck malignancies were retrospectively analyzed, with 43 cases (9.3%) diagnosed as non-SCC. The overall survival rate of patients with adenoid cystic carcinoma was significantly worse compared to that of patients with SCC. The 5-year survival rates were <50% for patients with malignant melanoma, adenocarcinoma, small-cell carcinoma and sarcomas. Distant metastasis to the lung was frequently observed in cases with a poor outcome. Non-SCC malignancies treated without surgery were associated with a worse outcome. Some non-SCC patients had a poor prognosis and distant metastasis was associated with an unsatisfactory outcome. Timely treatment and control of distant metastasis are essential and surgical treatment should be prioritized in non-SCC cases to improve patient outcomes.

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Treatment outcomes and prognostic features in adenoid cystic carcinoma originated from the head and neck

Cited by 74 publications

References 21 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

High Expression of H3K9me3 Is a Strong Predictor of Poor Survival in Patients With Salivary Adenoid Cystic Carcinoma

Controlling distant metastasis and surgical treatment are crucial for improving clinical outcome in uncommon head and neck malignancies, such as non-squamous cell carcinoma

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