title: Differences in patterns of survival in metastatic adenoid cystic carcinoma of the head and neck.
abstract: We examined the assumption in conventional teaching about metastatic adenoid cystic carcinoma (ACC) being an indolent type of disease.
  
  
  
  A single center analysis of 105 cases of ACC was performed. Radiographs were reviewed and tumor response to chemotherapy was measured. Distant disease-free survival (DDFS) and time to death since distant metastases diagnosis were analyzed.
  
  
  
  Forty-two percent of the patients were diagnosed with distant metastases. DDFS showed significant negative associations with advanced T classification, N+ classification, solid type tumor, and positive surgical margins. Distant metastases (91%) developed in the first 5 years after presentation. Median distant metastatic survival was 13.8 months. The most frequent organ sited was the lung. Solid type ACC showed a preponderance for multiorgan metastases (17/28; 61%). Distant metastases seemed not to occur in case of clear surgical margins. Solid type ACC had a significant poorer survival after development of distant metastases.
  
  
  
  Metastatic ACC is not always an indolent disease. © 2016 Wiley Periodicals, Inc. Head Neck 39: 456-463, 2017.
authors: Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors: Stijn
authors: S
authors: van Weert
authors: Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
authors: Rinze
authors: R
authors: Reinhard
authors: Department of Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA), Amsterdam, The Netherlands.
authors: Elisabeth
authors: E
authors: Bloemena
authors: Department of Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands.
authors: Jan
authors: J
authors: Buter
authors: Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors: Birgit I
authors: BI
authors: Witte
authors: Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.
authors: Marije R
authors: MR
authors: Vergeer
authors: Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors: C René
authors: CR
authors: Leemans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: adenoid cystic carcinoma; distant metastases; head and neck; patterns of survival; solid type histology