A Clinical Analysis in Adenoid Cystic Carcinoma of the Head and Neck

Park, Yoon Young; Shim, Yoon Sang; Oh, Kyung Kyoon; Lee, Yong Sik; Choi, Jin Ho

Abstract

BACKGROUND: Adenoid cystic carcinoma of the head and neck is relatively rare and is characterized by slow evolution, multiple recurrences, protracted clinical course, and distant metastases.
OBJECTIVES
We performed this study for the purpose of determining the effect of age and sex distribution, site, treatment modality, distant metastasis and stage on survival in adenoid cystic carcinoma of the head and neck. MATERIALS AND METHOD: This article presents the age and sex distribution, primary sites, treatment modalities according to different clinical stages, recurrence patterns, and 5 year survival rates in each cases by analyzing 55 patients of adenoid cystic carcinoma of the head and neck treated from 1985 to 1995 at Korea Cancer Center Hospital.
RESULTS
In 55 cases of adenoid cystic carcinomas, 27 were male and 28 were female. By age, 6th decades were most common. According to the primary site, major salivary gland origin were 20 cases and minor were 35 cases. 12 cases were stage 1, 18 cases were 2, 10 cases were 3, and 15 cases were 4. According to the treatment modality, 12 patients received surgery only, 31 patients received surgery and postoperative radiation therapy, and 9 patients received radiation therapy only. Among the 4 patients with distant metastases at diagnosis, 3 received chemotherapy. Local recurrence was identified in 12 cases, distant metastasis only was in 7 cases, and both were in 6 cases. Lung was the most common metastatic site. Overall 5 year survival rates were 77.1%. Age, sex, primary site, and treatment modality had no effect on 5 year survival rates. The clinical stage and distant metastasis had a significant impact on survival.
CONCLUSION
In adenoid cystic carcinoma of the head and neck, the most significant prognostic factors are clinical stage and distant metastasis. But, considering the slow growing features of tumor, long term follow up will be needed for the more accurate evaluation.