title: Pattern of recurrent disease in major salivary gland adenocystic carcinoma.
abstract: This study aims to evaluate the long-term outcome of major salivary gland adenocystic carcinoma (ACC). This is a retrospective review of 54 cases of ACC during a 35-year period from 1974 to 2009 at the Helsinki University Central Hospital, Helsinki, Finland. Medical records and histological samples were reviewed. All patients had a minimum follow-up time of 5 years or until death. Most of the tumours occurred in the parotid gland (n = 30, 56%) followed by submandibular gland (n = 22, 41%) and sublingual gland (n = 2, 4%). Fifty-two patients (96%) were treated with curative intent. All of these patients except one were primarily treated with surgery, and 29 patients (54%) also received postoperative radiotherapy for their primary tumour. Two patients (4%) received palliative radiotherapy. For those treated with curative intent, 32 patients (62%) had disease recurrence. Twenty-four patients (75%) had their first disease recurrence within 5 years and eight patients (25%) later than 5 years. The difference in the length of recurrence-free time interval (<5 vs. >5 years) had a significant impact on 5-year overall survival (OS) and disease-specific survival (DSS). The OS, DSS and disease-free survival (DFS) across stages I-IV varied between 46-100, 50-100 and 46-100%, respectively. Age over 45 years, T stage, and presence of neck metastases had a significant negative prognostic effect. More than half of the patients had recurrent disease. An extended follow-up for these patients seems feasible as most of the distant metastases were detected within a 10-year period.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, HUCH, P.O.Box 220, FI-00029, Helsinki, Finland, karoliina.hirvonen@hus.fi.
authors.forename: Karoliina
authors.initials: K
authors.lastname: Hirvonen
authors.forename: Leif
authors.initials: L
authors.lastname: Bäck
authors.forename: Kauko
authors.initials: K
authors.lastname: Saarilahti
authors.forename: Ilmo
authors.initials: I
authors.lastname: Leivo
authors.forename: Jaana
authors.initials: J
authors.lastname: Hagström
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy
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