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Patterns of recurrence and survival of head and neck adenoid cystic carcinoma after definitive resection†

  1. Agnes Oplatek MD1,2,*,
  2. Enver Ozer MD1,2,
  3. Amit Agrawal MD1,2,
  4. Sumit Bapna MD1,2,
  5. David E. Schuller MD1,2

Article first published online: 29 OCT 2009

DOI: 10.1002/lary.20684

Issue

The Laryngoscope

The Laryngoscope

Volume 120, Issue 1, pages 65–70, January 2010

Additional Information

How to Cite

Oplatek, A., Ozer, E., Agrawal, A., Bapna, S. and Schuller, D. E. (2010), Patterns of recurrence and survival of head and neck adenoid cystic carcinoma after definitive resection. The Laryngoscope, 120: 65–70. doi: 10.1002/lary.20684

Author Information

  1. 1

    Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Medical Center, Columbus, Ohio, U.S.A

  2. 2

    Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, U.S.A

*Department of Otolaryngology-Head and Neck Surgery, OSU Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212

  1. †

    Presented at the Combined Otolaryngology Spring Meeting, Phoenix, Arizona, U.S.A., May 28–31, 2009.

Publication History

  1. Issue published online: 16 DEC 2009
  2. Article first published online: 29 OCT 2009
  3. Manuscript Accepted: 21 JUL 2009

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Keywords:

  • Head and neck;
  • adenoid cystic cancer

Abstract

Objectives/Hypothesis:

To determine factors impacting recurrence and long-term survival of adenoid cystic carcinoma (ACC) of the head and neck after definitive resection.

Study Design:

Retrospective cohort study at an academic tertiary care hospital.

Methods:

Patients with ACC of the head and neck treated at our institution were reviewed. Those not receiving surgery, or with metastatic disease were excluded. Clinicopathological data on each patient was collected.

Results:

Of 113 patients identified with ACC, 99 were studied. The overall median survival for the cohort was 71 months (mean ± standard deviation, 94 ± 79 months). American Joint Committee on Cancer (AJCC) tumor stage and N stage were independent predictors of survival on multivariate analysis. Mean overall survival (P = .001) and time to recurrence (P = .006) were lower for patients with cervical lymph node positive disease (N+). Tumors in major salivary glands were associated with longer survival (P = .027). The overall recurrence rate was 53%, with a mean time to recurrence of 63 ± 64 months. The presence of lymphovascular invasion predicted recurrence on multivariate analysis (P = .002), with advanced tumor stage predicting early (≤36 months) recurrence (P = .013). Among the 57 patients who received adjuvant radiation therapy, there was no difference in survival, rate of recurrence, or time to recurrence, when compared to patients treated with surgery alone.

Conclusions:

Clinicopathological variables including AJCC tumor stage, tumor site, presence of N+ disease, and lymphovascular invasion may be used as prognostic factors in predicting survival and recurrence after a definitive resection of ACC of the head and neck. Laryngoscope, 2010

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