[Clinical analysis of 40 cases with sinonasal adenoid cystic carcinoma].
OBJECTIVE
To study the clinical characters and the mode of treatment, and to analyze the prognosis of patients with sinonasal adenoid cystic carcinoma.


METHODS
The clinical data were analyzed retrospectively in 40 patients with sinonasal adenoid cystic carcinoma. The characters of survival rate, local recurrence and distant metastasis in these patients were analyzed using Kaplan-Meier method and Log-rank test.


RESULTS
The maxillary sinus was the most common site of origin and account for 80% of all patients. Five-year and ten-year overall survival rate were 76.9% and 61.6% respectively. Five-year and ten-year disease-free survival rate were 44.2% and 23.0%. Five-year local recurrence rate and distant metastasis rate were 45.0% and 23.0%, respectively. The most common site of distant metastasis was lung. Presence of distant metastasis correlated with decreased 5-year survival (chi2=7.26, P=0.007). The distant metastasis rate of preoperative treatment (18.2%) seemed lower than that of postoperative treatment (38.9%), but there was no significant difference in the two groups (chi2=1.37, P=0.24). The combined therapy mainly composed of surgery was adopted to treat the local recurrence. Five-year survival rate after development of local recurrence was 60.0%.


CONCLUSIONS
Distant metastasis is an important factor affecting the prognosis of the patients with sinonasal adenoid cystic carcinoma. Combined therapy composed of surgery and radiation was the first choice of treatment to the patients with sinonasal adenoid cystic carcinoma. Radiation can play an important role in the treatment. The combined therapy mainly composed of surgery should be adopted in the patients with local recurrence to improve the survival rate.
Wei
Ming-hui
MH
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Tang
Ping-zhang
PZ
Xu
Zhen-gang
ZG
Qi
Yong-fa
YF
Yin
Yu-lin
YL
D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010255:Paranasal Sinus Neoplasms / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate