title: Adenoid cystic carcinoma of head and neck: A single institutional analysis of 66 patients treated with multi-modality approach.
abstract: BACKGROUND
  Adenoid cystic carcinoma (ACC) accounts for 1% of all head and neck (HN) cancers.
  
  
  METHODS
  Demographic, clinical, treatment, and survival details of 66 patients were collected (1995-2011) and analyzed. Disease-free survival (DFS) was estimated by Kaplan-Meier method.
  
  
  RESULTS
  Primary disease sites were sinonasal (n = 27), salivary gland (n = 30), and others (n = 9). Median follow-up was 23 months (range: 12-211 months). Estimated DFS at 2- and 5-year were 75% and 67.2%, respectively. On univariate analysis, intra-cranial extension (ICE) (hazard ratio [HR]: 3.59, P = 0.0071), lymph node involvement (HR: 4.05, P = 0.0065), treatment modality (others vs. surgery plus adjuvant radiotherapy, HR: 2.39, P = 0.0286) and T stage (T3/4 vs. T1/2, HR: 3.27, P = 0.007) had significant impact on DFS. Lymph node involvement (P = 0.038) and ICE (P = 0.038) continued to have significant impact on DFS on multivariate analysis.
  
  
  CONCLUSIONS
  Surgery followed by adjuvant radiotherapy remains the treatment of choice for HN ACC. Lymph node involvement and ICE confer poor prognosis.
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Ajeet Kumar
authors: AK
authors: Gandhi
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Soumyajit
authors: S
authors: Roy
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Ahitagni
authors: A
authors: Biswas
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Suman
authors: S
authors: Bhasker
authors: Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Atul
authors: A
authors: Sharma
authors: Department of Oto-rhino-laryngology, All India Institute of Medical Sciences, New Delhi, India.
authors: Alok
authors: A
authors: Thakar
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors: Bidhu Kalyan
authors: BK
authors: Mohanti
keywords: Adenoid cystic carcinoma; head and neck; radiotherapy; surgery