title: Patterns of recurrence and survival of head and neck adenoid cystic carcinoma after definitive resection.
abstract: OBJECTIVE
  To determine factors impacting recurrence and long-term survival of adenoid cystic carcinoma (ACC) of the head and neck after definitive resection.
  
  
  METHODS
  Retrospective cohort study at an academic tertiary care hospital.
  
  
  METHODS
  Patients with ACC of the head and neck treated at our institution were reviewed. Those not receiving surgery, or with metastatic disease were excluded. Clinicopathological data on each patient was collected.
  
  
  RESULTS
  Of 113 patients identified with ACC, 99 were studied. The overall median survival for the cohort was 71 months (mean +/- standard deviation, 94 +/- 79 months). American Joint Committee on Cancer (AJCC) tumor stage and N stage were independent predictors of survival on multivariate analysis. Mean overall survival (P = .001) and time to recurrence (P = .006) were lower for patients with cervical lymph node positive disease (N+). Tumors in major salivary glands were associated with longer survival (P = .027). The overall recurrence rate was 53%, with a mean time to recurrence of 63 +/- 64 months. The presence of lymphovascular invasion predicted recurrence on multivariate analysis (P = .002), with advanced tumor stage predicting early (<or=36 months) recurrence (P = .013). Among the 57 patients who received adjuvant radiation therapy, there was no difference in survival, rate of recurrence, or time to recurrence, when compared to patients treated with surgery alone.
  
  
  CONCLUSIONS
  Clinicopathological variables including AJCC tumor stage, tumor site, presence of N+ disease, and lymphovascular invasion may be used as prognostic factors in predicting survival and recurrence after a definitive resection of ACC of the head and neck.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA. agnes.oplatek@osumc.edu
authors.forename: Agnes
authors.initials: A
authors.lastname: Oplatek
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Sumit
authors.initials: S
authors.lastname: Bapna
authors.forename: David E
authors.initials: DE
authors.lastname: Schuller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D012469:Salivary Glands / Q000473:pathology