title: Elective neck dissection in patients with head and neck adenoid cystic carcinoma: an international collaborative study.
abstract: BACKGROUND
  Adenoid cystic carcinoma (ACC) accounts for 3-5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC.
  
  
  METHODS
  This retrospective multicentered study investigated 270 patients who underwent neck dissection. A multivariate analysis assessed associations of clinical and histopathologic characteristics with survival outcomes.
  
  
  RESULTS
  The primary tumor sites included the oral cavity in 250 patients (55 %), the major salivary glands in 133 patients (29 %), the sinonasal mucosa in 68 patients (15 %), and the larynx in six patients (1 %). The overall rate of occult nodal metastases among the patients who underwent END was 17 % (38/226). The highest incidence of occult nodal metastases was with the oral cavity (66 %). The 5-year overall survival (72 and 79 % for patients with or without END, respectively) and disease-specific survival (74 and 81 % for patients with or without END, respectively) were similar in the two groups. The subgroup analysis of patients according to the primary site showed no significant impact of END on outcome. In the multivariate analysis, primary site, T classification, and N classification were the only variables associated with outcome.
  
  
  CONCLUSIONS
  The incidence of occult neck metastases among patients with ACC is 17 %. The highest incidence of occult metastases is with the oral cavity. Statistical analysis showed no survival advantage for patients who underwent END compared with those who did not.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Clinical Research Institute at Rambam (CRIR), Rambam Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Amit
authors.forename: Shorook
authors.initials: S
authors.lastname: Na'ara
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: Joelle
authors.initials: J
authors.lastname: Glick
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: Bjoerndal
authors.forename: Christian
authors.initials: C
authors.lastname: Godballe
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.forename: Wolff
authors.initials: W
authors.lastname: Klaus-Dietrich
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: Ian
authors.initials: I
authors.lastname: Ganly
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D017558:Elective Surgical Procedures / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000401:mortality*; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult