Adenoid cystic carcinomas of the head and neck area: a retrospective study of 17 patients

Introduction:

The adenoid cystic carcinoma (ACC) as a rare tumor entity of the head and neck area paradoxically grows slowly with low proliferation rates, but locally aggressive and invasive. The ACC tends to local recurrences and haematogenic distant metastases. Treatment usually combines surgery and radiotherapy, although the role of radiotherapy (conventional vs. heavy ions) has not been investigated properly.

Methods:

We analyzed all patients of our clinic who were treated for ACC in the period of 2007 to 2018. In particular, the overall survival, local recurrences, distant metastases and type of treatment (OP, OP + adjuvant therapy (radio-/heavy ion therapy), primary radio-/heavy ion therapy) were evaluated.

Results:

17 patients could be identified with an ACC. In 5 patients the tumor was located in the paranasal sinuses (2 Pat. T3 with pos. LK, 2 T4), 1 in the oral cavity (T1), 6 in the pharynx (2 T2, 1 T3, 3 T4) and 5 in the salivary glands (1 T1, 2 T2, 2 T4 with pos. LN and pulmonary metastases (pm)). In 8 patients we found a local recurrence, 6 of them with pM. During the observation period 4 patients died (T4, 2 of them recurrence, 2 pm; 3 located in paranasal sinuses). 15 patients underwent surgery, of which 7 received adjuvant radio- and 5 heavy ion therapy afterwards. 2 received primary heavy ion therapy. There was no clear difference in survival between the therapeutic options. The correlation between the occurrence of local recurrences and pM was conspicuous.

Conclusion:

In our patient population we could not find any superiority of one type of treatment. In case of a local recurrence the patient should be investigated for pulmonary metastases.

Publication History

Publication Date:
23 April 2019 (online)