Clinical Paper
Head and Neck Oncology
Clinicopathological study of distant metastases of salivary adenoid cystic carcinoma

https://doi.org/10.1016/j.ijom.2013.04.006Get rights and content

Abstract

Most studies of the clinicopathological characteristics and prognosis of patients with distant metastasis of salivary adenoid cystic carcinoma (SACC) have used small patient samples. To further explore this issue, a descriptive and prognostic study of 467 patients with SACC who were treated from 1963 to 2009 was conducted at a single institution. One hundred and forty-five patients (31.0%) had distant metastases. At least 20% of patients who presented with the early-stage disease and no recurrence developed distant metastasis. The overall 5-, 10-, and 20-year survival rates were 85.6%, 67.4%, and 50.4%, respectively, for patients without distant metastasis, and 69.1%, 45.7%, and 14.3%, respectively, for patients with distant metastasis. The median survival time after distant metastasis was 36 months (range 1–112 months). The prognosis was similar between patients who received treatment for metastasis and those who did not. Patients who were diagnosed with early-stage disease and without local recurrence of the primary tumours could also develop distant metastases. The biological characteristics of adenoid cystic carcinoma were different from those of squamous cell carcinoma. At present, the effectiveness of treatment for distant metastases is not ideal and further research is needed.

Section snippets

Materials and methods

From 1963 to December 2009, 613 patients with SACC were admitted to the study institution. Among them, 467 patients (76.2%) were given follow-up. The follow-up period, defined as the period from the time of diagnosis of SACC to the time of last data collection or of the patient's death, ranged from 6 months to 32 years (median 12 years). The diagnosis of distant metastasis was confirmed by the histopathological examination of samples obtained by metastasectomy or by detection of metastasis by

General clinical data

Of the 467 patients with SACC who had available clinicopathological and follow-up information, 210 (45.0%) were male and 257 (55.0%) were female. Their ages ranged from 16 to 80 years, with a median age of 47 years. Two hundred and thirty-two patients (49.7%) had SACC of the minor salivary glands and 235 patients (50.3%) had SACC of the major salivary glands.

Distant metastasis rate and sites

One hundred and forty-five patients (31.0%) had distant metastasis among the 467 SACC patients with follow-up. The lung was the

Discussion

SACC is characterized by the persistent and indolent growth of the primary tumours and a high incidence of hematogenous metastasis, which ranges from 8.5% to 58.8%.1, 2, 3, 4, 5, 6, 7, 8 The lung is the predominant anatomical site of distant metastasis. However, SACC can also metastasize to bone, liver, the cerebrum, and to multiple organs.1, 3, 6, 9, 10, 11 van der Wal et al. reported that 28 of 51 patients with SACC developed distant metastasis, an incidence of 54.9%. Among those 28 patients,

Funding

None.

Competing interests

None.

Ethical approval

Not required.

References (27)

  • J. Fordice et al.

    Adenoid cystic carcinoma of the head and neck: predictors of morbidity and mortality

    Arch Otolaryngol Head Neck Surg

    (1999)
  • D.E. Perez et al.

    Prognostic factors in head and neck adenoid cystic carcinoma

    Oral Oncol

    (2006)
  • G.T. Budd et al.

    Adenoid cystic carcinoma of the salivary gland: sustained complete response to chemotherapy

    Cancer

    (1983)
  • Cited by (99)

    • Pathology Mimicking Orofacial Pain

      2023, Dental Clinics of North America
    View all citing articles on Scopus
    View full text