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DOI: 10.1055/s-0034-1370476
International Collaborative Validation of Intraneural Invasion as a Prognostic Marker in Adenoid Cystic Carcinoma of the Head and Neck
Background: This study aimed to characterize the incidence, pattern of spread and prognostic correlation of nerve invasion (NI) in patients with adenoid cystic carcinoma (ACC).
Methods: Using 3 different pathological categories of perineural invasion, intraneural invasion and perineural inflammation, we investigated the prognostic value of NI in a total of 495 ACC from 9 international patient cohorts with median follow up 90 months (range 12–288).
Results: With Of 239(48%) patients with NI, 174(73%) had perineural invasion, 65(27%) intraneural invasion and 37 (15%) perineural inflammation. Multivariate Cox regression analysis identified tumor site (p = 0.008, HR = 1.8, 95% CI = 0.07–3.7) and intraneural invasion (p < 0.001, HR = 5.9, 95%CI = 0.8–12.3) as independent prognostic markers for both overall and disease-specific survival, but not of distant metastases.
Conclusions: While perineural invasion has no impact on survival, intraneural invasion is an independent predictor of poor prognosis. Recognition of intraneural invasion may help optimize treatment of patient with head and neck ACC.