The impact of clinicopathological factors on clinical outcomes in patients with salivary gland adenoid cystic carcinoma:
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ORIGINAL ARTICLE
The impact of clinicopathological factors on clinical outcomes in patients with salivary gland adenoid cystic carcinoma: a multi‑institutional analysis in Japan Daisuke Kawakita1 · Takayuki Murase2 · Kaori Ueda2,3 · Satoshi Kano4 · Yuichiro Tada5 · Kiyoaki Tsukahara6 · Kenji Okami7 · Tetsuro Onitsuka8 · Yasushi Fujimoto9 · Takuma Matoba1 · Kazuo Sakurai10 · Toru Nagao3 · Nobuhiro Hanai11 · Ryo Kawata12 · Naohito Hato13 · Ken‑ichi Nibu14 · Makoto Urano15 · Ken‑ichi Taguchi16 · Masato Nakaguro17 · Kimihide Kusafuka18 · Hidetaka Yamamoto19 · Toshitaka Nagao20 · Hiroshi Inagaki2 Received: 27 February 2020 / Accepted: 11 June 2020 © Japan Society of Clinical Oncology 2020
Abstract Background Owing to the low incidence of adenoid cystic carcinoma (AdCC), reliable survival estimates and prognostic factors remained unclarified. Methods In this multi-institutional retrospective analysis, we collected 192 AdCC cases, and investigated the impact of clinicopathological factors on clinical outcomes of the patients. All AdCC cases were of salivary gland origin and were surgically treated with curative intent. Diagnoses of AdCC were validated by a central pathology review by expert pathologists. Results The 5-year overall survival (OS) and disease-free survival (DFS) rates were 92.5 and 50.0%, respectively. Treatment failure occurred in 89 patients (46%) with the distant failures in 65 (34%). Multivariate analysis indicated that pN2 and a pathologically positive surgical margin were independent prognostic factors for both OS and DFS. Histological grade III was an independent prognostic factor for OS. A primary site in the submandibular gland, pT3/4, pN1, and histological grade II were independent prognostic factors for DFS. Postoperative radiation therapy (PORT) improved the locoregional control (LRC) rate. Prophylactic neck dissection was not associated with a better OS or better LRC among patients with cN0. Facial nerve dissection did not improve clinical outcomes in parotid AdCC cases without facial nerve palsy. Conclusions A higher TN classification, a pathologically positive surgical margin, and a higher histological grade were associated with a lower OS. PORT improved LRC rates but neck dissection failed to improve clinical outcomes in patients with cN0. As the distant metastasis was frequent, effective systemic therapy is imperative to improve the survival of AdCC patients. Keywords Adenoid cystic carcinoma · Salivary gland · Clinicopathological analysis · Prognostic analysis · And multiinstitutional analysis
Introduction Adenoid cystic carcinoma (AdCC), although one of the most common carcinomas of the salivary gland, is rare accounting for less than 1% of all head and neck cancers and less than 10% of all salivary gland tumors [1]. This tumor is Daisuke Kawakita and Takayuki Murase contributed equally to this work. * Hiroshi Inagaki [email protected]‑cu.ac.jp Extended author information available on the last page of the article
slow-growing, but its long-term prognosis is poor with a 10-year
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