Risk factors for survival and distant metastasis in 125 patients with head and neck adenoid cystic carcinoma undergoing primary surgery

Jeong, In Seong; Roh, Jong-Lyel; Cho, Kyung-Ja; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

doi:10.1007/s00432-020-03170-5

Original Article – Clinical Oncology
Published: 06 March 2020

Risk factors for survival and distant metastasis in 125 patients with head and neck adenoid cystic carcinoma undergoing primary surgery

In Seong Jeong¹,
Jong-Lyel Roh ORCID: orcid.org/0000-0002-1537-1977²,
Kyung-Ja Cho³,
Seung-Ho Choi¹,
Soon Yuhl Nam¹ &
Sang Yoon Kim¹

Journal of Cancer Research and Clinical Oncology volume 146, pages 1343–1350 (2020)Cite this article

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Abstract

Purpose

Adenoid cystic carcinoma (AdCC) is generally slow growing but has highly metastatic potential to distant organs. Several factors and biomarkers are associated with metastasis and treatment outcomes, although further definition is needed. Therefore, this study aimed to evaluate the risk factors for survival and distant metastasis in patients with head and neck AdCC.

Methods

This study included 125 patients with previously untreated AdCC who underwent primary surgery with or without radiotherapy in our tertiary referral centre. Univariate and multivariate Cox proportional hazard regression analyses were used to identify risk factors associated with overall survival (OS), cause-specific survival (CSS), disease-free survival (DFS), and distant metastasis-free survival (DMFS). Factors associated with OS in patients with distant metastasis were separately analysed.

Results

During a median follow-up of 9.8 years (range 3.0–22.6 years), 58 patients (46.4%) had distant metastasis and 29 (23.2%) died of disease. Multivariate analyses showed that lymphovascular invasion, lymph node metastasis, and distant metastasis were independent factors of OS and CSS outcomes (all P < 0.05). The T classification and extranodal extension were independent factors of DFS and DMFS outcomes (P < 0.05). After patients presented with distant metastasis, the median survival was 5.8 years. Multivariate analyses showed that extranodal extension and regional recurrence were independent factors of survival after occurrence of distant metastasis (P < 0.05).

Conclusion

Several clinicopathological factors can predict distant metastasis and survival of patients with AdCC treated with primary surgery. This may promote post-treatment surveillance in patients with AdCC.

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Funding

This study was supported by the National Research Foundation of Korea (NRF) Grant, funded by the Ministry of Science and ICT (MSIT), the Government of Korea (No. 2019R1A2C2002259) (J.-L.R.).

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Affiliations

Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
In Seong Jeong, Seung-Ho Choi, Soon Yuhl Nam & Sang Yoon Kim
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, 13496, Republic of Korea
Jong-Lyel Roh
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Kyung-Ja Cho

Authors

In Seong Jeong
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Jong-Lyel Roh
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Kyung-Ja Cho
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Seung-Ho Choi
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Soon Yuhl Nam
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Sang Yoon Kim
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Corresponding author

Correspondence to Jong-Lyel Roh.

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The authors have no conflict of interest to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research board, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent from all individual participants was waved because of the retrospective nature of this study.

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Jeong, I.S., Roh, JL., Cho, KJ. et al. Risk factors for survival and distant metastasis in 125 patients with head and neck adenoid cystic carcinoma undergoing primary surgery. J Cancer Res Clin Oncol 146, 1343–1350 (2020). https://doi.org/10.1007/s00432-020-03170-5

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Received: 25 November 2019
Accepted: 27 February 2020
Published: 06 March 2020
Issue Date: May 2020
DOI: https://doi.org/10.1007/s00432-020-03170-5

Keywords

Adenoid cystic carcinoma
Head and neck
Distant metastasis
Survival
Risk factors