Article ; Online: Salivary gland adenoid cystic carcinoma in the U.S population: Importance of grade, site of metastases, and adjuvant radiation for survival.
American journal of otolaryngology
2024 Volume 45, Issue 3, Page(s) 104266
Abstract: Background: Adenoid cystic carcinoma (AdCC) is a rare and relatively heterogenous salivary gland malignancy, for which there is debate regarding grading, and clinical prognostic factors, including the role of adjuvant radiotherapy.: Methods: ... ...
Abstract | Background: Adenoid cystic carcinoma (AdCC) is a rare and relatively heterogenous salivary gland malignancy, for which there is debate regarding grading, and clinical prognostic factors, including the role of adjuvant radiotherapy. Methods: Surveillance, Epidemiology, and End Results (SEER) data were reviewed for AdCC cases from 2000 to 2018. Results: A total of 1978 patients with AdCC were identified. Most patients were between 50 and 59 years of age (21.4 %), female (59.9 %), and Caucasian (76.8 %). Most tumors were localized at presentation (44.3 %), and moderately differentiated (or grade II) (43.7 %). Overall and DSS 5-year survival rates were 70.7 % (95 % CI, 69.9-78.8), and 78.6 % (95 % CI, 77.6-79.6). The best overall 5-year survival rate was observed for those treated with surgery plus radiation, 76.8 % (95 % CI, 75.5-78.1). Multivariate analysis revealed male sex, age > 65 (H.R. 2.659 (95 % CI,2.291-3.098), p < .001), grade III/IV (H.R.5.172 (95 % CI, 3.418-7.824), p < .001), nodal metastasis, distant metastasis (H.R. 2.400 (95 % CI, 2.178-2.645), p < .001), chemotherapy only, and combination therapy as negative prognostic factors, and receiving surgery plus radiation therapy (H.R.0.586 (95 % CI, 0.505-0.679), p < .001) as a positive prognostic factor. When limited just to the lungs, had much better survival than those patients with distant metastases to other sites such as the bones and liver (p < .001). Conclusion: This SEER study identifies grade, particularly III and IV, to be the strongest single predictor of worse survival. Patients did best when treated with surgery and postoperative radiotherapy. These results can inform future management of patients with this challenging cancer type. |
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MeSH term(s) | Humans ; Carcinoma, Adenoid Cystic/mortality ; Carcinoma, Adenoid Cystic/radiotherapy ; Carcinoma, Adenoid Cystic/pathology ; Carcinoma, Adenoid Cystic/therapy ; Salivary Gland Neoplasms/pathology ; Salivary Gland Neoplasms/mortality ; Salivary Gland Neoplasms/radiotherapy ; Salivary Gland Neoplasms/therapy ; Male ; Female ; Middle Aged ; Radiotherapy, Adjuvant ; Aged ; Survival Rate ; United States/epidemiology ; SEER Program ; Neoplasm Grading ; Adult ; Prognosis ; Young Adult ; Aged, 80 and over ; Neoplasm Metastasis ; Age Factors |
Language | English |
Publishing date | 2024-03-20 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 604541-8 |
ISSN | 1532-818X ; 0196-0709 |
ISSN (online) | 1532-818X |
ISSN | 0196-0709 |
DOI | 10.1016/j.amjoto.2024.104266 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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