Recurrence after Treatment of Salivary Gland Adenoid Cystic Carcinoma

Kwon, Min Su; Roh, Jong Lyel; Choi, Seung Ho; Kim, Sang Yoon; Nam, Soon Yuhl

Abstract

BACKGROUND AND OBJECTIVES
Adenoid cystic carcinoma of salivary glands has distinct characteristics of indolent but persistent growth, late onset of metastasis and eventual death of patients. We performed this study to find parameters affecting the recurrence and survival of patients with adenoid cystic carcinoma in salivary glands.
SUBJECTS AND METHOD
A retrospective study was done on 55 patients who underwent surgery between 1990 and 2006. We analyzed the effect of patient's factors, characteristics of tumor and treatment modalities to local recurrence, distant metastasis and survival.
RESULTS
There were 20 males and 35 females, with the median age of 50.2 years. The mean follow-up duration after treatment was 70.9 months. Patients who received surgery alone were 12 (22%), with radiation therapy were 34 (62%) and with concurrent chemoradiation therapy were 9 (16%). There were 7 patients who had local recurrence alone, 8 who had distant metastasis alone and 3 who had local recurrence with distant metastasis. There was no correlation between the above parameters and local recurrence. Distant metastasis was influenced by old age (p=0.018), lymph node involvement (p=0.005) and treatment with concurrent chemoradiation therapy (p<0.001). Eight patients died during the follow up period. Five-year overall survival rate was 88.2% and the disease-free survival was 72.9%. The multivariate analysis found that only lymph node involvement was associated with survival (p=0.043).
CONCLUSION
Lymph node involvement was predictive of poor prognosis in salivary adenoid cystic carcinoma. Therefore, it is necessary to establish highly sensitive diagnostic tools with which surgeons can find lymph node involvement.