[Prognostic analysis of adenoid cystic carcinoma of major salivary glands of 64 cases].

BACKGROUND & OBJECTIVE: Adenoid cystic carcinoma of salivary glands is a kind of highly malignant tumor, and researches on the tumors originated from major salivary glands are rare. This study was to investigate prognostic factors of adenoid cystic carcinoma of major salivary glands.

METHODS

Clinical records of 64 patients with adenoid cystic carcinoma of major salivary glands followed up for more than 7 years were reviewed. Cumulative survival rate was analyzed by the Kaplan-Meier method. The log-rank test was applied to compare survival rates, and the comparison of the percentage of subjects between two groups was conducted with Chi2 test.

RESULTS

The overall death rate was 57.8%; the cause-specific death rate was 46.9%; the 5-and 10-year cumulative survival rates were 65.63% and 54.52%, respectively; the relapse rate was 34.4%; and the metastasis rate was 45%. Univariate analysis revealed that the factors impacting the prognosis were age, presence or absence of nerve invasion, histological subtypes, clinical stage, positive or negative surgical margin. Patients aged > or = 50, presence of nerve invasion, solid/tubular subtype, advanced clinical stage (stages III and IV), and positive surgical margin had poorer prognosis than those aged < 50, absence of nerve invasion, cribriform subtype, early clinical stage (stages I and II), and negative surgical margin. Multivariate analysis showed that the presence of nerve invasion, solid histological subtype, advanced clinical stage (stages III and IV), and positive surgical margin were independently associated to poor prognosis.

CONCLUSION

Presence or absence of nerve invasion, histological subtype, clinical stage, and positive or negative surgical margin are the independent factors affecting the prognosis of patients with adenoid cystic carcinoma of salivary glands.