Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Oral Oncol. 2013 Aug;49(8):824-9. doi: 10.1016/j.oraloncology.2013.05.004. Epub 2013 Jun 14.
Adenoid cystic carcinoma is a rare salivary gland malignancy with a poor disease free survival due to frequent distant metastases and late local recurrences. Previous single-center reports on outcome mostly encompass small series. In this report a relative large series of 105 cases is analyzed, all treated at the VU University Medical Center, Amsterdam, The Netherlands over a 30-year period in which treatment strategies remained unchanged.
All cases of ACC of the head and neck between 1979 and 2009 at our institution were analyzed through a medical chart review. Recurrence patterns and possible prognostic factors (T-stage, N-status, age, gender, type of salivary gland involved, histological grade, surgical margins, perineural invasion (PNI) and postoperative radiotherapy (RT)) were analyzed.
One-hundred and five cases of ACC of the head and neck were identified. Five-, ten- and twenty-year survival rates for overall survival were 68%, 52% and 28%, respectively. T-stage, N-status, surgical margins, histological subtype and age were highly significant predictors for survival. PNI was not a negative prognosticator.
T-stage, N-status, surgical margins, histological grade and age are the main predictors of survival-outcome in ACC of the head and neck. Distant metastasis frequently develop, mainly in the first 5 years post treatment. Local recurrences often develop even later on, warranting long term follow up of patients treated for ACC. Grade III ACC should be considered a specific entity within the group of ACC due to its typical aggressive biological behavior and relatively poor outcome, implicating the need for an improved adjuvant treatment.
腺样囊性癌是一种罕见的唾液腺癌，由于频繁的远处转移和晚期局部复发，其无疾病生存率较差。以前的单中心报告大多包括小系列。在本报告中，分析了一个相对较大的 105 例病例系列，这些病例均在荷兰阿姆斯特丹 VU 大学医学中心治疗，治疗时间为 30 年，治疗策略保持不变。
通过病历回顾，分析了本机构 1979 年至 2009 年间发生的所有头颈部腺样囊性癌病例。分析了复发模式和可能的预后因素（T 期、N 期、年龄、性别、受累涎腺类型、组织学分级、手术切缘、神经周围侵犯（PNI）和术后放疗（RT））。
共发现 105 例头颈部腺样囊性癌病例。总生存率的 5、10 和 20 年生存率分别为 68%、52%和 28%。T 期、N 期、手术切缘、组织学亚型和年龄是生存的高度显著预测因子。PNI 不是一个负面的预后因素。
T 期、N 期、手术切缘、组织学分级和年龄是头颈部腺样囊性癌生存结果的主要预测因子。远处转移通常在治疗后 5 年内发生，局部复发通常更晚发生，这需要对接受腺样囊性癌治疗的患者进行长期随访。由于其典型的侵袭性生物学行为和相对较差的预后，III 级 ACC 应被视为 ACC 组中的一个特定实体，需要改进辅助治疗。
