Treatment outcomes of sinonasal adenoid cystic carcinoma: 30 cases from a single institution.
OBJECTIVE
To establish the clinical features and prognostic factors of sinonasal adenoid cystic carcinoma (ACC).


METHODS
Thirty patients with histopathological diagnosis of sinonasal ACC who were treated at Severance Hospital between 1990 and 2010 were included in this retrospective chart review study.


RESULTS
The 5-year disease-specific survival and disease-free survival rates were 75.3% and 37.2%, respectively. The maxillary sinus (63.3%) and nasal cavity (23.3%) were the most common sites of primary tumour. Most patients were diagnosed with advanced-stage (III/IV) disease (80.0%) and had undergone surgery and postoperative radiotherapy (70.0%). The most common histopathological subtype was cribriform type (40.9%). Local recurrence rate and distant metastasis rates were 26.7% and 23.3%, respectively. The mean time from primary treatment to recurrence was 44.5 months. Sinonasal ACC patients with stage IV and T4 disease had significantly worse survival than those with low stage and T disease. Patients with local recurrence had worse disease-specific survival than those with distant recurrence. Distant metastasis was associated with disease-free survival but not disease-specific survival.


CONCLUSIONS
Despite the frequent occurrence of distant metastasis, early diagnosis and effective local control seemed to be the most important factors influencing the survival of sinonasal ACC.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sang Yeob
SY
Seong
Department of Otorhinolaryngology, Kang-Dong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Dong Woo
DW
Hyun
Department of Otorhinolaryngology, Ajou University College of Medicine, Suwon, Republic of Korea.
Yoo Suk
YS
Kim
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Hyung-Ju
HJ
Cho
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Jeung-Gweon
JG
Lee
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Joo-Heon
JH
Yoon
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: entman@yuhs.ac.
Chang-Hoon
CH
Kim
D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000601:surgery; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
Adenoid cystic carcinoma; Nasal cavity; Paranasal sinus; Prognostic factors; Survival