title: Lymph node involvement predicts poor prognosis in primary tongue adenoid cystic carcinoma: A preliminary study of 54 cases.
abstract: OBJECTIVE
  Primary tongue adenoid cystic carcinoma (ACC) is extremely rare. The relationship between the patient's prognosis and the tumor's clinicopathological characteristics is uncertain. The aim of this study was to identify the prognostic factors and analyze the overall outcomes for patients with tongue ACC.
  
  
  METHODS
  A retrospective analysis of the medical records of patients diagnosed with primary tongue ACC between 1998 and 2008 was conducted. The study comprised 54 patients, with a median age of 53.4 years. The incidence of ACC in the base of the tongue was almost 3.5 times in comparison to that in the mobile portion of the tongue. The 3-year and 5-year overall survival rates were 87.4% and 65.3%, respectively, whereas the 3-year and 5-year disease-free survival rates were 54.3% and 32.8%, respectively. Significant prognostic factors regarding overall survival in univariate analyses included tumor size and lymph node status.
  
  
  RESULTS
  A multivariate model identified lymph node status as the only significant independent predictor of overall survival. Further analysis showed that tumor size (P = 0.034), histological grade (P = 0.021), and perineural invasion (PNI, P = 0.023) were three important factors affecting lymph node metastasis. Patients with lymph node metastasis have a higher tendency of developing distant metastasis (P < 0.01).
  
  
  CONCLUSIONS
  Lymph node status was a significant determinant of prognosis in primary tongue ACC and could be used for a rational design of treatment strategies in future.
authors.affiliation: Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology (Head: Pro. Chenping Zhang), 639 Zhizaoju Road, Luwan District, Shanghai 200011, PR China.
authors.forename: Nannan
authors.initials: N
authors.lastname: Han
authors.affiliation: Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology (Head: Pro. Chenping Zhang), 639 Zhizaoju Road, Luwan District, Shanghai 200011, PR China.
authors.forename: Huishan
authors.initials: H
authors.lastname: Ong
authors.affiliation: Department of Stomatology, Taizhou Municipal Hospital Affiliated with Taizhou University (Head: Pro. Zhihui Liu), 381 East Road of Zhongshan, Taizhou, Zhejiang 318000, PR China. Electronic address: liuzhihui1209@sina.com.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology (Head: Pro. Chenping Zhang), 639 Zhizaoju Road, Luwan District, Shanghai 200011, PR China. Electronic address: doctorruanmin78@hotmail.com.
authors.forename: Min
authors.initials: M
authors.lastname: Ruan
authors.affiliation: Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology (Head: Pro. Chenping Zhang), 639 Zhizaoju Road, Luwan District, Shanghai 200011, PR China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology (Head: Pro. Chenping Zhang), 639 Zhizaoju Road, Luwan District, Shanghai 200011, PR China.
authors.forename: Chenping
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000556:secondary*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000401:mortality* / Q000473:pathology*
keywords: Adenoid cystic carcinoma (ACC); Lymph node metastasis; Prognosis; Tongue