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Annals of Surgical Oncology

, Volume 22, Issue 4, pp 1353–1359 | Cite as

Elective Neck Dissection in Patients With Head and Neck Adenoid Cystic Carcinoma: An International Collaborative Study

  • Moran Amit
  • Shorook Na’ara
  • Kanika Sharma
  • Naomi Ramer
  • Ilana Ramer
  • Abib Agbetoba
  • Joelle Glick
  • Xinjie Yang
  • Delin Lei
  • Kristine Bjoerndal
  • Christian Godballe
  • Thomas Mücke
  • Wolff Klaus-Dietrich
  • André M. Eckardt
  • Chiara Copelli
  • Enrico Sesenna
  • Frank Palmer
  • Ian Ganly
  • Ziv Gil
Head and Neck Oncology

Abstract

Background

Adenoid cystic carcinoma (ACC) accounts for 3–5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC.

Methods

This retrospective multicentered study investigated 270 patients who underwent neck dissection. A multivariate analysis assessed associations of clinical and histopathologic characteristics with survival outcomes.

Results

The primary tumor sites included the oral cavity in 250 patients (55 %), the major salivary glands in 133 patients (29 %), the sinonasal mucosa in 68 patients (15 %), and the larynx in six patients (1 %). The overall rate of occult nodal metastases among the patients who underwent END was 17 % (38/226). The highest incidence of occult nodal metastases was with the oral cavity (66 %). The 5-year overall survival (72 and 79 % for patients with or without END, respectively) and disease-specific survival (74 and 81 % for patients with or without END, respectively) were similar in the two groups. The subgroup analysis of patients according to the primary site showed no significant impact of END on outcome. In the multivariate analysis, primary site, T classification, and N classification were the only variables associated with outcome.

Conclusions

The incidence of occult neck metastases among patients with ACC is 17 %. The highest incidence of occult metastases is with the oral cavity. Statistical analysis showed no survival advantage for patients who underwent END compared with those who did not.

Keywords

Overall Survival Oral Cavity Neck Dissection Adenoid Cystic Carcinoma Occult Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of Interest

There are no conflicts of interest.

Supplementary material

10434_2014_4106_MOESM1_ESM.tiff (1.1 mb)
Supplemental Figure 1 Kaplan-Meier analysis. Five-year (A) overall survival and (B) disease-specific survival rates calculated by the Kaplan-Meier method according to nodal status in patients undergoing elective neck dissection. pN = pathological nodal status. (TIFF 1149 kb)
10434_2014_4106_MOESM2_ESM.tiff (1.2 mb)
Supplemental Figure 2 Analysis of outcome measures in patients with ACC. Five-year (A) disease-free survival (B) local control, (C) distant metastases rates and (D) regional control calculated by the Kaplan-Meier method according to nodal status in patients undergoing elective neck dissection. pN = pathological nodal status (TIFF 1242 kb)

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Moran Amit
    • 1
    • 8
  • Shorook Na’ara
    • 1
    • 8
  • Kanika Sharma
    • 2
    • 8
  • Naomi Ramer
    • 3
    • 8
  • Ilana Ramer
    • 3
    • 8
  • Abib Agbetoba
    • 4
    • 8
  • Joelle Glick
    • 4
    • 8
  • Xinjie Yang
    • 5
    • 8
  • Delin Lei
    • 5
    • 8
  • Kristine Bjoerndal
    • 6
    • 8
  • Christian Godballe
    • 6
    • 8
  • Thomas Mücke
    • 7
    • 8
  • Wolff Klaus-Dietrich
    • 7
    • 8
  • André M. Eckardt
    • 8
    • 9
  • Chiara Copelli
    • 8
    • 10
  • Enrico Sesenna
    • 8
    • 10
  • Frank Palmer
    • 8
    • 11
  • Ian Ganly
    • 8
    • 11
  • Ziv Gil
    • 8
    • 1
  1. 1.Department of Otolaryngology Head and Neck Surgery, Clinical Research Institute at Rambam (CRIR), Rambam Medical CenterThe Technion, Israel Institute of TechnologyHaifaIsrael
  2. 2.Department of Radiotherapy and OncologyMax Cancer CenterNew DelhiIndia
  3. 3.Departments of Pathology Mount Sinai Medical CenterThe Mount Sinai School of MedicineNew YorkUSA
  4. 4.Otolaryngology, Mount Sinai Medical CenterThe Mount Sinai School of MedicineNew YorkUSA
  5. 5.Department of Oral and Maxillofacial Surgery, School of Stomatology The Fourth Military Medical UniversityXi′anPeople’s Republic of China
  6. 6.Department of Otolaryngology Head and Neck SurgeryOdense University HospitalOdenseDenmark
  7. 7.Department of Oral and Maxillofacial SurgeryKlinikum Rechts der Isar, Technische Universität MünchenMünchenGermany
  8. 8.Department of Otolaryngology Head and Neck SurgeryTel Aviv Medical CenterTel AvivIsrael
  9. 9.Department of Cranio-Maxillofacial SurgeryHannover Medical SchoolHannoverGermany
  10. 10.Maxillo-Facial SurgeryUniversity-Hospital of ParmaParmaItaly
  11. 11.Head and Neck Surgery ServiceMemorial Sloan Kettering Cancer CenterNew YorkUSA

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