The treatment results and prognostic factors of adenoid cystic carcinoma of the salivary gland :analysis of 126 cases

Objective To summarize the results of treatment of adenoid cystic carcinoma of the salivary glands of head and neck and to evaluate factors implicated in local recurrence and survival. Methods A retrospective analysis was performed on 126 cases with adenoid cystic carcinoma of the salivary glands. Results The overall local recurrent rate was 35%. In 80% of cases, radiotherapy was effective. The overall 5 ,10 and 20 year accumulative survival were 81.7%,63.8% and 37.0%, respectively. The recurrence free accumulative survival of 5 ,10 ,and 20 year were 87.6%, 77.0%,and 73.1%,respectively.Overall local control rates of 5 ,10 ,and 20 year were 85.7%,60.1%,and 29.4%,respectively .Regional lymph node metastasis rate was 10%, lung metastasis 24%. Six prognostic variables were analysed for local recurrence and survival. There was impact of the treatment fashion, tumor histological features and marginal status on local recurrence; and that of tumor histological features ,surgical margin and regional lymph node status on the survival. Conclusions Adenoid cystic carcinoma of the salivary gland is a slow growing tumor. Surgery is the treatment of choice. Radiotherapy may control disease growth effectively. Combined modality is indicated for patients with positive surgical margin and locally advanced disease.