Highlights
- •The 5-year OS and DFS were 92.8% and 76.2%, respectively.
- •Male sex, higher T/N status, and high grade were independently associated with a worse DFS.
- •T3–T4 status and intermediate/high histological grade were associated with N+ status.
- •After PS matching, prophylactic ND was associated with a trend toward a better DFS.
Abstract
Background
Acinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The
aim of this work was to analyse data from the national REFCOR multicenter cohort (i)
to investigate the prognostic factors influencing survival outcomes in AciCC, (ii)
to assess the impact on survival of postoperative radiotherapy (RT) in patients treated
for AciCC without high-grade transformation and (iii) to explore the prognostic impact
of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary
glands.
Patients and methods
Data from all the patients treated for salivary AciCC between 2009 and 2020 were extracted
from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free
Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate
analyses. Propensity score matching was used to assess the impact of postoperative
RT and prophylactic ND on DFS.
Results
A total of 187 patients were included. After a median follow-up of 53 months, their
5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis,
male sex, older age, higher T and N status, and high grade were independently associated
with a worse DFS. In the subpopulation analysed after propensity score matching, patients
with cN0 AciCC without high-grade transformation who were treated by surgery and RT
did not have an improved DFS compared to patients who were treated by surgery alone
(hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3–T4
status and intermediate/high histological grade. After propensity score matching,
prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16).
Conclusions
These results suggest that (i) long-term follow-up (>5 years) should be considered
in patients with AciCC, (ii) treatment by surgery alone could be an option in selected
cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND
may be considered preferentially in patients with T3–T4 status and/or intermediate/high
histological grade.
Keywords
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Article info
Publication history
Published online: March 01, 2023
Accepted:
February 22,
2023
Received in revised form:
February 17,
2023
Received:
December 27,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
