title: Clinicopathologic predictors of recurrence and overall survival in adenoid cystic carcinoma of the head and neck: a single institutional experience at a tertiary care center.
abstract: BACKGROUND
  The purpose of this study was to determine factors that impact recurrence and long-term survival of head and neck adenoid cystic carcinoma (ACC).
  
  
  METHODS
  We conducted a retrospective review of 87 patients with head and neck ACC who were evaluated between 1992 and 2009. Staining for Ki-67, p53, α-estrogen receptor (αER), and progesterone receptor (PR) was performed.
  
  
  RESULTS
  Forty men (46%) and 47 women (54%) were included in this study. Median follow-up for patients was 98 months. Five-year recurrence-free and overall survival (OS) rates were 56% and 81%, respectively. Ki-67 and p53 expression was observed in 5 (6%) and 2 (2%) patients, respectively. αER and PR were all negative. The most important determinants of disease-free survival (DFS) were perineural invasion (PNI; p = .001) and female sex (p = .027). Disease site (major vs minor salivary gland) was the only predictor of worse OS on multivariate analysis.
  
  
  CONCLUSIONS
  Perineural invasion, female sex, and disease site were the most consistent predictors of poor outcome in head and neck ACC.
authors.affiliation: Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Anna
authors.initials: A
authors.lastname: Marcinow
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
authors.forename: Theodoros
authors.initials: T
authors.lastname: Teknos
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.forename: Agnes
authors.initials: A
authors.lastname: Hurtuk
authors.forename: Matthew
authors.initials: M
authors.lastname: Old
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Ricardo
authors.initials: R
authors.lastname: Carrau
authors.forename: Obiajulu H
authors.initials: OH
authors.lastname: Iwenofu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: adenoid cystic carcinomas; disease-free survival; head and neck; overall survival; prognostic factors