Adenoid cystic carcinoma of the head and neck: a single-institution's analysis of 45 consecutive cases over a 29-year period

Objective A series of patients with head and neck adenoid cystic carcinoma (ACC) was studied with respect to treatment modalities, recurrence, survival and prognostic factors. Study Design Between August 1984 and December 2013, 45 patients with ACC of the head and neck who were primary surgically treated at our institution were retrospectively reviewed. Results Disease-specific survival (DSS) rates at 5, 10, and 15 years were 85%, 79.4%, and 65.7%, respectively. Tumors of the major salivary glands had a better DSS. Patients with ACC of the paranasal sinuses or nasal cavity had poorer survival compared with other head and neck subsites, although this correlation did not reach statistically significant level. DSS rates were 81.5% at 5 years, 70.5% at 10 years, and 31.3% at 15 years for patients with perineural invasion (PNI) compared with 88.9% for those patients who did not have PNI ( P  = .01). Follow-up ranged from 7 to 337 months (mean 129.4 months). Conclusions ACC is a unique malignant salivary gland tumor associated with prolonged survival even in metastatic settings, which emphasizes the necessity for lifetime follow-up as well as more active oncologic treatment. In our study, survival was adversely affected by the primary tumor site and PNI.