Prognostic factors of palatal adenoid cystic carcinoma: A single-center analysis of 85 cases

Laryngoscope Investig Otolaryngol. 2024 Mar 23;9(2):e1236. doi: 10.1002/lio2.1236. eCollection 2024 Apr.

Abstract

Objective: The purpose of this retrospective study was to describe the clinicopathological characteristics of primary adenoid cystic carcinoma (ACC) of the palate and to identify the factors affecting prognosis.

Methods: The medical records of 85 patients with primary ACC of the palate treated with surgery, with or without adjuvant radiotherapy/chemotherapy, from 2009 to 2019 were reviewed. The relationship of different clinical parameters with locoregional recurrence (LR), distant metastasis (DM), and overall survival (OS) were analyzed.

Results: Median follow-up time was 44.6 months. LR and DM rates were 24.7% and 25.9%, respectively, and the 5-year OS and disease-free survival (DFS) rates were 85.9% and 55.1%, respectively. Multivariate analysis showed that positive margins were independently associated with the risk of LR (p < .001). Positive margins (p = .001) and high histological grade (p = .031) were significantly associated with shorter OS.

Conclusion: Positive surgical margins are a strong adverse prognostic factor affecting LR and OS in patients with ACC; apart from that, high histopathological grade is an independent predictor of poor OS.

Level of evidence: Level 3 (Prognosis - Cohort study).

Keywords: adenoid cystic carcinoma; margins of excision; palate; prognosis; salivary gland neoplasms.