[Clinical analysis of 42 cases with adenoid cystic carcinoma of the nasal cavity].

OBJECTIVE

To study the clinical characters, treatment, outcome and the factors affecting long-term treatment results of adenoid cystic carcinoma (ACC) of the nasal cavity.

METHOD

The clinical data were analyzed retrospectively in 42 patients with ACC of the nasal cavity treated initially. The characters of survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Factors that might be related to the prognosis were analyzed by Log-rank test.

RESULT

The 5-,10-,15-,20-year cumulative overall survival and disease-free survival rate were 88.1%, 54.4%, 35.4%, 35.4% and 60.0%, 53.1%, 30.2%, 30.2% respectively. The 5-,10-,15-,20-year cumulative local control rate were 69.5%, 62.3%, 49.8%, 49.8% respectively and the cumulative distant metastasis rate were 22.2%, 25.9%, 34.2%, 34.2% respectively. Clinical T stage was the factor affecting local control and survival (P<0.05). There was no difference in survival for patients treated by surgery along with sufficient margins, compared with patients treated by surgery combined with postoperative radiation. Patients treated with preoperative radiation had poorer local control and survival than patients treated with postoperative radiation, but there was no statistical significance (P>0.05). The most of patients (75%) died of local recurrence at the primary site.

CONCLUSION

The most frequent site of failure was local recurrence at the primary site. Patients with early stage disease are amenable to surgery alone with sufficient margins. Surgery combined with high-dose postoperative radiation improves the local control and survival in patients with positive margins, no sufficient margins or advanced disease (T3 + T4). The most of tumors could be reduced remarkably and the radical operation may be performed for the patients with unresectable advanced tumors after preoperative radiation.