Prognosis and risk factors for early-stage adenoid cystic carcinoma of the major salivary glands


BHAYANI M. K., Yener M., EL-NAGGAR A., GARDEN A., HANNA E. Y., WEBER R. S., ...Daha Fazla

CANCER, cilt.118, sa.11, ss.2872-2878, 2012 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 118 Sayı: 11
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1002/cncr.26549
  • Dergi Adı: CANCER
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.2872-2878
  • Anahtar Kelimeler: adenoid cystic carcinoma, early-stage, distant metastasis, chemotherapy, salivary gland, DISTANT METASTASIS, NECK, HEAD, CANCER, SURVIVAL, RADIOTHERAPY, EXPERIENCE, PREDICTORS, SURGERY
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır

Özet

BACKGROUND: Adenoid cystic carcinoma (ACC) is characterized by slow growth, frequent local recurrences, and distant metastasis (DM). However, these findings frequently are reported in patients with advanced-stage tumors, but the outcomes of early-stage tumors are poorly defined. We sought to evaluate the risk factors for the development of DM in early-stage ACC. METHODS: We retrospectively reviewed the charts of 60 patients who were diagnosed with clinical early-stage (T1-2/N0) ACC to determine the risk factors for development of DM and survival of these patients. RESULTS: DM was detected in 12 (20%) of the patients, with a median latency of 31.5 months after diagnosis. Univariate analysis revealed that DM was associated with age =45 years, pathologically positive lymph nodes, extracapsular spread (ECS) from lymph nodes, high-grade histology, and solid tumor subtype. Multivariate analysis revealed solid tumor subtype and ECS to be significantly associated with DM. Disease-specific survival rates at 5 and 10 years for patients with DM were 80% and 40%, respectively, and were both 100% for patients without DM. CONCLUSION: Although the majority of patients with clinical early-stage ACC of the major salivary glands have favorable prognosis, a significant percentage of patients will develop DM. Solid tumor subtype and nodal ECS were independent predictors of DM in early-stage ACC of major salivary glands. Other clinical and pathological variables may also contribute. These subgroups had poor overall and disease-specific survival. Such patients should be observed closely for the development of DM. Systemic therapy should be considered at the time of diagnosis. Cancer 2011. (c) 2011 American Cancer Society.