Adenoid cystic carcinoma of the head and neck: a retrospective multicenter study

Abstract

Background: Adenoid cystic carcinoma of the head and neck (ACCHN) is rare and difficult to study effective treatment at one institute. Our aim is to identify prognostic factors for this disease by conducting a multicenter study at 11 institutions in Japan.

Methods: A retrospective multicenter study of ACCHN was performed. One hundred and three patients were identified between 2006 and 2015. The overall survival (OS) rate for all patients was calculated, and OS, locoregional control (LRC) rate, or no distant metastasis (NDM) rate was calculated for patients in that the surgery was performed without distant metastasis (DM). Statistical analyses were performed.

Results: A significant difference with multivariate analysis was observed in patients in sublingual glands, stage IV and the use of radiation therapy ≥60Gy (sufficient RT) in OS for all patients. A significant difference was observed in the use of sufficient postoperative RT in the OS and the LRC rate, and in pathological surgical margins in the NDM rate.

Conclusion: Sublingual glands or stage IV was a poorer, and sufficient RT was a better prognostic factor for ACCHN. Sufficient RT was effective to prevent local recurrence after surgical resection. Positive surgical margins caused an increase in DM.

Chinese abstract

背景：头颈部腺样囊性癌（ACCHN）是罕见的, 难以在一个机构研究其有效的治疗方法。我们的目标是, 通过在日本的11个机构进行多中心研究, 来确定这种疾病的预后因素。

方法：对ACCHN进行回顾性多中心研究。在2006年至2015年期间选定了一百三十名患者。计算了所有患者的总体生存（OS）率, 并对手术时无远处转移（DM）的患者计算了OS、局部控制（LRC）率或无远处转移（NDM）率。还进行了统计学分析。

结果：在舌下腺、IV期患者和使用放射治疗60Gy以上（足够RT）的患者中, 对所有患者的OS多变量分析中观察到显着性差异。在OS和LRC率上使用足够的术后RT, 以及NDM率的病理手术切缘中, 观察到显着性差异。

结论：舌下腺或IV期是ACCHN的较差的预后因子, 而足够RT是较好的预后因子。足够RT可有效预防手术切除后局部复发。正面手术切缘引起DM的增加。

Keywords:

• Adenoid cystic carcinoma
• multicenter study
• dose of radiation therapy
• head and neck

Acknowledgments

We appreciate the expert assistance of Professor Tsuyoshi Morimoto (Department of Clinical Epidemiology, Hyogo College of Medicine) for statistical advice.

Disclosure statement

We have no conflict of interest to disclose in relation to our paper.

Additional information

Funding

This work was not funded by any grant other than our clinical salaries at each hospital.