Clinicopathologic predictors of recurrence and overall survival in adenoid cystic carcinoma of the head and neck: a single institutional experience at a tertiary care center

Head Neck. 2014 Dec;36(12):1705-11. doi: 10.1002/hed.23523. Epub 2014 Feb 1.

Abstract

Background: The purpose of this study was to determine factors that impact recurrence and long-term survival of head and neck adenoid cystic carcinoma (ACC).

Methods: We conducted a retrospective review of 87 patients with head and neck ACC who were evaluated between 1992 and 2009. Staining for Ki-67, p53, α-estrogen receptor (αER), and progesterone receptor (PR) was performed.

Results: Forty men (46%) and 47 women (54%) were included in this study. Median follow-up for patients was 98 months. Five-year recurrence-free and overall survival (OS) rates were 56% and 81%, respectively. Ki-67 and p53 expression was observed in 5 (6%) and 2 (2%) patients, respectively. αER and PR were all negative. The most important determinants of disease-free survival (DFS) were perineural invasion (PNI; p = .001) and female sex (p = .027). Disease site (major vs minor salivary gland) was the only predictor of worse OS on multivariate analysis.

Conclusion: Perineural invasion, female sex, and disease site were the most consistent predictors of poor outcome in head and neck ACC.

Keywords: adenoid cystic carcinomas; disease-free survival; head and neck; overall survival; prognostic factors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Adenoid Cystic / mortality*
  • Carcinoma, Adenoid Cystic / pathology*
  • Carcinoma, Adenoid Cystic / therapy
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Survival Rate
  • Tertiary Care Centers
  • Treatment Outcome
  • Young Adult