ADENOID CYSTIC CARCINOMA: LONG-TERM EXPERIENCE AT A TERTIARY CARE CENTER

Presentation: B021
Topic: Clinical Research
Type: Poster
Date:
Session:
Authors: Mark Mims, Phillip Huyett, Seungwon Kim
Institution(s): UPMC
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Importance:  Adenoid cystic carcinoma is one of the most common salivary gland malignancies and carries with it a grave prognosis. Due to its tendency for perineural invasion, the clinical course is often marked with local recurrences and high rates of metastasis with a large portion of cases succumbing to their disease.  Treatment of the disease typically involves resection and adjuvant radiation therapy, with or without concurrent chemotherapy. Many molecular markers have been examined to determine prognostic significance in adenoid cystic carcinoma with mixed results. Overall 10-year survival rates range from 52-65% with significant decreases in survival beyond 10 years. Many small case series exist in the literature for adenoid cystic carcinoma, but few large volume series have been published.

Objective:  To report the experience of a large tertiary cancer center in patients with adenoid cystic carcinoma.

Design: Retrospective review of patients with adenoid cystic carcinoma over a 15-year period.

Setting: University tertiary cancer center

Participants: All patients with primary adenoid cystic carcinoma of the salivary glands undergoing their primary treatment at the university hospital and with records available in the EMR.

Main outcomes: Primary endpoints included overall survival and disease-free survival.

Results:  There were 97 total cases of adenoid cystic carcinoma over the 15-year study period, 47 male and 50 female. Thirty arose from major salivary glands (15 from parotid and 15 from submandibular gland) and 67 from various minor salivary glands from nasal cavity to base of tongue. All patients underwent primary surgical resection, including 32 with concomitant neck dissection. Seventy-one underwent adjuvant radiation therapy with 68 receiving concurrent chemotherapy. Twenty-one developed recurrence and 33 patients developed metastasis, with the most common sites of metastasis being lung and bone. 84.2% of cases demonstrated perineural invasion on pathologic examination. Overall 5-year survival was 40.8% and overall 10-year survival was 23.7%. Average disease free survival was 4.0 years with an average follow up of 5.4 years (range 0.1 years to 21.6 years).

Conclusion and Relevance:  Adenoid cystic carcinoma is a high grade malignancy with tendency of local recurrence and distant metastasis due to perineural invasion. This study reports on 97 new cases of adenoid cystic carcinoma at a tertiary cancer center.

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