Adenoid cystic carcinoma of the nasal cavity and paranasal sinuses: a meta-analysis.
Objectives To identify independent predictors of outcome in patients with adenoid cystic carcinoma (ACC) of the paranasal sinuses and skull base. Design Meta-analysis of the literature and data from the International ACC Study Group. Setting University-affiliated medical center. Participants The study group consisted of 520 patients, 99 of them from the international cohort. The median follow-up period was 60 months (range, 32 to 100 months). Main Outcome Measures Overall survival (OS) and disease-specific survival (DSS). Results The 5-year OS and DSS of the entire cohort were 62% and 67%, respectively. The local recurrence rate was 36.6%, and the regional recurrence rate was 7%. Distant metastasis, most commonly present in the lung, was recorded in 106 patients (29.1%). In the international cohort, positive margins and ACC of the sphenoid or ethmoidal sinuses were significant predictors of outcome (p < 0.001). Perineural invasion and adjuvant treatment (radiotherapy or chemoradiation) were not associated with prognosis. Conclusion Tumor margin status and tumor site are associated with prognosis in ACC of the paranasal sinuses, whereas perineural invasion is not. Adjuvant treatment apparently has no impact on outcome.
Department of Otolaryngology, Head and Neck Surgery, Rambam Medical Center, Haifa and Israel Institute of Technology, Technion, Haifa, Israel.
Moran
M
Amit
Department of Otolaryngology, Head and Neck Surgery, Rambam Medical Center, Haifa and Israel Institute of Technology, Technion, Haifa, Israel.
Yoav
Y
Binenbaum
Department of Radiotherapy & Oncology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
Kanika
K
Sharma
Department of Pathology, Mount Sinai Medical Center, New York, New York, USA.
Naomi
N
Ramer
Ramer
R
Naomi
epartment of Pathology, Mount Sinai Medical Center, New York, New York, USA.
Ilana
I
Ramer
D
Ramer
R
Ilana
Department of Otolaryngology, The Mount Sinai School of Medicine, New York, New York, USA.
Abib
A
Agbetoba
Agbetoba
A
Abib
Department of Otolaryngology, The Mount Sinai School of Medicine, New York, New York, USA.
Brett
B
Miles
Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, P. R. China.
Xinjie
X
Yang
Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, P. R. China.
Delin
D
Lei
Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
Kristine
K
Bjoerndal
Bjoerndal
B
Kristine
Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
Christian
C
Godballe
Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
Godballe
G
Christian
Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, Technische Universität München, München, Germany.
Thomas
T
Mücke
Mücke
M
Thomas
Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, Technische Universität München, München, Germany.
Klaus-Dietrich
KD
Wolff
Wolff
W
Klaus-Dietrich
Department of Otolaryngology Head and Neck Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.
Dan
D
Fliss
Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
André M
AM
Eckardt
Maxillo-Facial Surgery, University-Hospital of Parma, Parma, Italy.
Chiara
C
Copelli
Copelli
C
Chiara
Maxillo-Facial Surgery, University-Hospital of Parma, Parma, Italy.
Enrico
E
Sesenna
Head and Neck Surgery Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Frank
F
Palmer
Palmer
P
Frank
Head and Neck Surgery Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Snehal
S
Patel
Department of Otolaryngology, Head and Neck Surgery, Rambam Medical Center, Haifa and Israel Institute of Technology, Technion, Haifa, Israel.
Ziv
Z
Gil
adenoid cystic carcinoma; meta analysis; paranasal sinuses; skull base; survival