Management and outcome of adenoid cystic carcinoma of the major salivary glands: the 22-year experience of a single institution

Abstract

Background

Prognostic factors and survival rate are difficult to determine for adenoid cystic carcinoma(AdCC) of salivary glands.

Aims/objectives

To clarify the clinical characteristics of AdCC and examine factors associated with recurrence and prognosis by histopathological grade classification.

Materials and methods

Twenty-five patients with AdCC of the parotid gland and 10 patients with AdCC of the submandibular gland were included. We classified AdCC histopathologically by the proportion of solid components. Clinical features, fine-needle aspiration cytology (FNAC), and patient outcomes were examined according to grade. Factors associated with local recurrence and distant metastases were examined.

Results

Age was significantly higher in the grade III group than in the grade I group. The grade III group had significantly higher proportions of patients with cN+, pN+, and perineural invasion. In FNAC, lower-grade groups showed higher rates of correct histopathological type. Five-year disease-specific survival and disease-free survival rates were significantly lower in the grade III than in the grade I. Distant metastases were more common among patients with high-stage and perineural invasion.

Conclusions

Five-year survival is significantly worse in patients with grade III.

Chinese Abstract

背景：唾液腺的腺样体囊性癌 (AdCC)的预后因素和生存率难以确定。

目的：按照组织病理学等级分类, 阐明 AdCC 的临床特征并检查复发及预后的相关因素。

材料和方法：纳入25 名腮腺 AdCC 患者和 10 名下颌下腺 AdCC 患者。 我们根据固体成分的比例, 对AdCC进行组织病理学分类。 根据等级, 检查临床特征、细针穿刺细胞学 (FNAC) 和患者治疗结果, 检查了与局部复发和远处转移相关的因素。

结果：三级组的年龄明显高于 一 级组。 三级组有明显更高比例的 cN+、pN+ 和神经周围浸润患者。 对于FNAC, 低级组表现出更高比率的正确组织病理学类型。 三级组的五年特定疾病生存率和无病生存率明显低于 一级组。远处转移在高阶段和神经周围浸润的患者中更为常见。

结论：三级患者的五年生存率明显更差。

Keywords:

• Parotid carcinoma
• submandibular carcinoma
• adenoid cystic carcinoma
• grade
• recurrence
• outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).