title: Incidence of cervical lymph node metastasis and its association with outcomes in patients with adenoid cystic carcinoma. An international collaborative study.
abstract: BACKGROUND
  The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established.
  
  
  METHODS
  We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection.
  
  
  RESULTS
  The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival.
  
  
  CONCLUSIONS
  Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity.
authors: Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.|The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam Rambam Medical Center, the Technion, Israel Institute of Technology, Israel.
authors: Moran
authors: M
authors: Amit
authors: The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam Rambam Medical Center, the Technion, Israel Institute of Technology, Israel.
authors: Yoav
authors: Y
authors: Binenbaum
authors: The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam Rambam Medical Center, the Technion, Israel Institute of Technology, Israel.
authors: Kanika
authors: K
authors: Sharma
authors: Department of Radiotherapy and Oncology, Max Cancer Center, New Delhi, India.
authors: Naomi
authors: N
authors: Ramer
authors: Department of Radiotherapy and Oncology, Max Cancer Center, New Delhi, India.
authors: Ilana
authors: I
authors: Ramer
authors: Mount Sinai Medical Center, Department of Pathology, The Mount Sinai School of Medicine, New York, New York.
authors: Abib
authors: A
authors: Agbetoba
authors: Mount Sinai Medical Center, Department of Pathology, The Mount Sinai School of Medicine, New York, New York.
authors: Joelle
authors: J
authors: Glick
authors: Department of Otolaryngology, The Mount Sinai School of Medicine, New York, New York.
authors: Xinjie
authors: X
authors: Yang
authors: Department of Otolaryngology, The Mount Sinai School of Medicine, New York, New York.
authors: Delin
authors: D
authors: Lei
authors: Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, People's Republic of China.
authors: Kristine
authors: K
authors: Bjørndal
authors: Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, People's Republic of China.
authors: Christian
authors: C
authors: Godballe
authors: Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
authors: Thomas
authors: T
authors: Mücke
authors: Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
authors: Klaus-Dietrich
authors: KD
authors: Wolff
authors: Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors: Dan
authors: D
authors: Fliss
authors: Department of Otolaryngology Head and Neck Surgery, Tel Aviv Medical Center, Tel Aviv, Israel.
authors: André M
authors: AM
authors: Eckardt
authors: Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
authors: Chiara
authors: C
authors: Copelli
authors: Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
authors: Enrico
authors: E
authors: Sesenna
authors: Maxillo-Facial Surgery, University-Hospital of Parma, Italy.
authors: Frank
authors: F
authors: Palmer
authors: Maxillo-Facial Surgery, University-Hospital of Parma, Italy.
authors: Ian
authors: I
authors: Ganly
authors: Maxillo-Facial Surgery, University-Hospital of Parma, Italy.
authors: Snehal
authors: S
authors: Patel
authors: Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.|The Laboratory for Applied Cancer Research, the Clinical Research Center at Rambam Rambam Medical Center, the Technion, Israel Institute of Technology, Israel.|Head and Neck Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Ziv
authors: Z
authors: Gil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: adenoid cystic carcinoma; incidence; lymph node; metastasis; survival