title: Analysis of failure in patients with adenoid cystic carcinoma of the head and neck. An international collaborative study.
abstract: BACKGROUND
  Adenoid cystic carcinoma (ACC) is a locally aggressive tumor with a high prevalence of distant metastases. The purpose of this study was to identify independent predictors of outcome and to characterize the patterns of failure.
  
  
  METHODS
  An international retrospective review was conducted of 489 patients with ACC treated between 1985 and 2011 in 9 cancer centers worldwide.
  
  
  RESULTS
  Five-year overall-survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were 76%, 80%, and 68%, respectively. Independent predictors of OS and DSS were: age, site, N classification, and presence of distant metastases. N classification, age, and bone invasion were associated with DFS on multivariate analysis. Age, tumor site, orbital invasion, and N classification were independent predictors of distant metastases.
  
  
  CONCLUSIONS
  The clinical course of ACC is slow but persistent. Paranasal sinus origin is associated with the lowest distant metastases rate but with the poorest outcome. These prognostic estimates should be considered when tailoring treatment for patients with ACC.
authors.affiliation: The Laboratory for Applied Cancer Research, Rambam Medical Center, Rappaport Medical School, The Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Amit
authors.forename: Yoav
authors.initials: Y
authors.lastname: Binenbaum
authors.forename: Kanika
authors.initials: K
authors.lastname: Sharma
authors.forename: Naomi
authors.initials: N
authors.lastname: Ramer
authors.forename: Ilana
authors.initials: I
authors.lastname: Ramer
authors.forename: Abib
authors.initials: A
authors.lastname: Agbetoba
authors.forename: Brett
authors.initials: B
authors.lastname: Miles
authors.forename: Xinjie
authors.initials: X
authors.lastname: Yang
authors.forename: Delin
authors.initials: D
authors.lastname: Lei
authors.forename: Kristine
authors.initials: K
authors.lastname: Bjøerndal
authors.forename: Christian
authors.initials: C
authors.lastname: Godballe
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.forename: Dan
authors.initials: D
authors.lastname: Fliss
authors.forename: André M
authors.initials: AM
authors.lastname: Eckardt
authors.forename: Chiara
authors.initials: C
authors.lastname: Copelli
authors.forename: Enrico
authors.initials: E
authors.lastname: Sesenna
authors.forename: Frank
authors.initials: F
authors.lastname: Palmer
authors.forename: Snehal
authors.initials: S
authors.lastname: Patel
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
keywords: adenoid; adenoid cystic; adenoid cystic carcinoma; head and neck cancer; salivary gland tumors