Adenoid cystic carcinoma of head and neck: clinical predictors of outcome from a Canadian centre

  • J.J. Ko University of Calgary
  • J.E. Siever Alberta Health Services
  • D. Hao University of Calgary
  • R. Simpson University of Calgary
  • H.Y. Lau University of Calgary
Keywords: Adenoid cystic carcinoma, head-and-neck cancer, prognostic factors

Abstract

Objectives

Adenoid cystic carcinoma (acc) is often treated with surgery, with or without adjuvant radiation therapy (rt). We evaluated disease characteristics, treatments, and potentially prognostic variables in patients with acc.

Methods

Our retrospective analysis considered consecutive cases of acc presenting at a tertiary care hospital between 2000 and 2014. Factors predictive of overall survival (os) and disease-free survival (dfs) were identified by univariate analysis.

Results

The 60 patients analyzed had a mean age of 58 years (range: 22–88 years), with a 2:1 female:male ratio. Tumour locations included the major salivary glands (40% parotid, 17% submandibular and sublingual), the oro-nasopharyngeal cavity (27%), and other locations (16%). Of the 60 patients, 35 (58%) received surgery with adjuvant rt; 12 (20%), rt only; 13 (22%), surgery only. Of 18 patients (30%) who experienced a recurrence within 5 years, 3 (5%) developed local recurrence only, and the remaining 15 (25%), distant metastasis. The 5-year os and dfs were 64.5% [95% confidence interval (ci): 45.9% to 78.1%] and 46.2% (95% ci: 29.7% to 61.2%) respectively. In patients without recurrence, 5-year os was 77% (95% ci: 52.8% to 89.9%), and in patients with recurrence, it was 42.7% (95% ci: 15.8% to 67.6%). Patients treated with rt only had a 5-year os of 9.2%. Predictors of 5-year dfs were TNM stage, T stage, nodal status, treatment received, and margin status; age, nodal status, treatment received, and margin status predicted 5-year os.

Conclusions

Despite surgery and rt, one third of patients with acc experience distant recurrence. Patients whose tumours are not amenable to surgery have a poor prognosis, indicating a need for alternative approaches to improve outcomes.

Author Biographies

J.J. Ko, University of Calgary
Department of Medical Oncology, Tom Baker Cancer Centre
J.E. Siever, Alberta Health Services

Department of Biostatistics, Public Health Innovation and Decision Support Population and Public Health

D. Hao, University of Calgary
Department of Medical Oncology, Tom Baker Cancer Centre
R. Simpson, University of Calgary
Department of Pathology, Foothills Medical Centre
H.Y. Lau, University of Calgary
Department of Oncology
Published
2015-11-20
How to Cite
Ko, J., Siever, J., Hao, D., Simpson, R., & Lau, H. (2015). Adenoid cystic carcinoma of head and neck: clinical predictors of outcome from a Canadian centre. Current Oncology, 23(1), 26-33. https://doi.org/10.3747/co.23.2898
Section
Radiation Oncology