Highlights
- •Head and neck adenoid cystic carcinoma occur more frequently in women (sex ratio: 1.5).
- •Age, body mass index and N stage are the three main clinical prognostic factors influencing event-free survival.
- •Tumour size, perineural invasion and the presence of histological grade III also have a negative influence on prognosis.
Abstract
Background
Adenoid cystic carcinoma (ACC) accounts for 1% of malignant head and neck tumours
[1] and 10% of salivary glands malignant tumours. The main objective of our study
is to investigate the prognostic factors influencing the event-free survival (EFS)
of patients with ACC.
Patients and methods
A multicentre prospective study was conducted from 2009 to 2018. All 470 patients
with ACC whose survival data appear in the REFCOR database were included in the study.
The main judgement criterion was EFS. Both a bivariate survival analysis using log-rank
test and a multivariate using Cox model were performed using the R software.
Results
Average age was 55 years. Females accounted for 59.4% of the cohort. The body mass
index (BMI) was normal in 86% of cases. Tumours were located in minor salivary glands
in 60% of cases. T3/T4 stages represented 58%; 89% of patients were cN0. histological
grade III was observed on 21% of patients. The EFS and overall 5-year survival rates
were 50% and 85%, respectively. After adjustment, the most significant pejorative
prognostic factors were age ≥65 years (hazard ratio [HR] = 1.67), BMI<16.5 (HR = 2.62),
and lymph node invasion cN (HR = 2.08).
Conclusion
Age, BMI and N stage are the three main clinical prognostic factors determining EFS
identified in this prospective series of patients with ACC. Such findings open new
research perspectives on the influence of these components on initial patient care.
Keywords
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Article info
Publication history
Published online: March 11, 2020
Accepted:
January 28,
2020
Received in revised form:
January 14,
2020
Received:
September 29,
2019
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
