Abstract
Objective: Evaluate the role of adjuvant radiation compared with surgical resection alone in treatment of adenoid cystic carcinoma of the head and neck. In addition, given the varied course and presentation of the disease, to analyze the impact of perineural invasion, margin status, and AJCC Tumor stage on survival.
Method: Retrospective review of 92 patients treated for adenoid cystic carcinoma of the head and neck between 1978 and 2010 at a single tertiary care academic center. Kaplan-Meier survival curves and Cox Proportional Hazards Model were used to evaluate the impact of treatment modality and clinical and pathological parameters on survival.
Results: The oropharynx was the most common site (30.4%). Overall 2-, 5-, and 10-year survival rates were 75%, 51%, and 22%. Mean follow-up was 75.9 months. All but 3 patients were treated with surgery and 60 out of 92 (65.2%) underwent postoperative radiation. Mean time to recurrence was 45.6 months and occurred in 45 out of 90 patients (50%). Significantly more T3/T4 staged patients underwent surgery plus adjuvant radiation than T1/T2 patients (P < .045).
Conclusion: Despite being classified with more advanced disease (T3/T4 Stage), patients in the surgery plus radiation group had similar outcomes to patients who received surgery alone. Adjuvant radiation should be considered in all patients with adenoid cystic carcinoma of the head and neck.
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