Effect Of Surgery And Adjuvant Radiotherapy On Overall Survival For Non-metastatic Adenoid Cystic Carcinoma Of The Head And Neck: A Seer Population Analysis

Presentation: S258
Topic: Salivary Gland
Type: Oral
Date: Monday, July 18, 2016
Session: 3:45 PM - 5:15 PM Potpourri II
Authors: Brian J Mitchell, DO1, Jeff Bunn, MD1, Jason Call, MD2, Robert Fairbanks, MD2, Wayne Lamoreaux, MD2, Danko Martincic, MD2, Aaron Wagner, MD2, Ben Peressini2, Chris Lee, MD2
cyklokapron canada skibsfartmedicin.site cyklokapron virkning
amitriptylin nervesmerter amitriptylin kardiotoxisk amitriptylin dak 10 mg
imipramin zulassung imipramin uses imipramin 25 mg
Institution(s): 1Providence Spokane Head, Neck and Thyroid Center, 2Cancer Care Northwest

PURPOSE: The effect of surgical resection (SR) and/or adjuvant radiotherapy (RT) on overall survival (OS) for patients with non-metastatic (distant metastases) adenoid cystic carcinoma of the head and neck has not been clearly established. We utilized a large United States population database to analyze the survival outcomes  of patients with non-metastatic adenoid cystic carcinoma of the head and neck who were treated with SR or RT and the impact of pre-treatment clinical factors.

METHODS AND MATERIALS: Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2012.  The primary endpoint was overall survival (OS). Cox regression analysis was used to perform univariate and multivariate analyses of the following clinical variables: age at diagnosis, race, gender, addition of adjuvant radiotherapy, surgery (yes or no), extent of surgery, lymph node involvement, tumor size, and primary site of origin.

RESULTS: The records for 1,595 patients with non-metastatic adenoid cystic carcinoma of the head and neck were obtained from the SEER database. Patients with previous malignancy, distant disease, incomplete or conflicting records, and/or atypical histologic features were excluded from this analysis. Of the patients eligible for analysis, 1,116 had undergone adjuvant RT. Median OS time was 174 months (+/- 17.61).  Univariate analysis revealed younger age at diagnosis, surgery performed, gross resection type, no lymph node involvement, smaller tumor size, and major salivary gland primary tumor site to be prognostic for a statistically improved overall survival (p<0.001).  Multivariate analysis revealed also that younger age at diagnosis, surgery performed, gross resection type, no lymph node involvement, smaller tumor size, and major salivary gland and palate primary tumor sites to be prognostic for a statistically improved overall survival (p<.001). The addition of adjuvant RT was not associated with an improvement in overall survival for patients.

CONCLUSION: As one of the largest population analyses to date of non-metastatic adenoid cystic carcinoma of the head and neck, this study reveals that age at diagnosis, absence or lymph node involvement, smaller tumor size, and extent of surgery were positive predictors for statistically significant improvements in OS. Adjuvant RT was not associated with an improvement in long-term OS. Further clinical studies will be needed to further elucidate the impact of surgical resection type and adjuvant radiotherapy techniques on local regional control and risk of distant metastases.

mometason dosering mometason herpes mometason rezeptfrei