Outcomes and Prognostic Variables in Adenoid Cystic Carcinoma of the Head and Neck: A Recent Experience

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• 作者：Daniel R. Gomez ; Bradford S. Hoppe ; Suzanne L. Wolden ; Joanne E. Zhung ; Snehal G. Patel ; Dennis H. Kraus ; Jatin P. Shah ; Ronald A. Ghossein ; Nancy Y. Lee
• 关键词：Adenoid cystic ; Salivary gland ; Head and neck ; Perineural invasion ; T stage
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2008
• 期刊代码：136_03603016
• 类别：med
• 出版时间：1 April 2008
• 卷：70
• 期：5
• 页码：1365-1372
• 文件大小：241 K

摘要

Materials and Methods: A retrospective analysis of 58 patients undergoing surgery for ACC of the head and neck at the University of Pittsburgh Medical Center from 1974 to 1994 was performed. Patients were followed up for a minimum of 24 months for the development of recurrent disease. The association of recurrence was correlated with clinical factors (age, sex, site, and stage); postoperative treatment (radiation therapy v no radiation); and pathologic variables (grade, margins of resection, and perineural invasion), and appropriate statistical analysis was performed.

Results: Recurrent disease developed in 59%of patients, despite the addition of postoperative radiation therapy in 83%of patients. Tumor site was the single most important factor for the development of locally recurrent disease and was correlated with primary tumor stage and resection margins. Local recurrence rates were decreased (P = .07) in patients with negative surgical margins who were irradiated.

Conclusions: Larger perspective randomized trials are necessary to evaluate the efficacy of postoperative radiation, and new treatments need to be investigated to improve local control rates for ACC of the head and neck.