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

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Conflict of Interest

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Clinical Research Institute at Rambam (CRIR), Rambam Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel

    Moran Amit MD, Shorook Na’ara MD & Ziv Gil MD, PhD

  2. Department of Radiotherapy and Oncology, Max Cancer Center, New Delhi, India

    Kanika Sharma MD

  3. Departments of Pathology Mount Sinai Medical Center, The Mount Sinai School of Medicine, New York, NY, USA

    Naomi Ramer DMD & Ilana Ramer MD

  4. Otolaryngology, Mount Sinai Medical Center, The Mount Sinai School of Medicine, New York, NY, USA

    Abib Agbetoba MD & Joelle Glick MD

  5. Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi′an, People’s Republic of China

    Xinjie Yang MD, PhD & Delin Lei MD

  6. Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Odense, Denmark

    Kristine Bjoerndal MD, PhD & Christian Godballe MD, PhD

  7. Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, Technische Universität München, München, Germany

    Thomas Mücke MD, DDS & Wolff Klaus-Dietrich MD, DDS, PhD

  8. Department of Otolaryngology Head and Neck Surgery, Tel Aviv Medical Center, Tel Aviv, Israel

    Moran Amit MD, Shorook Na’ara MD, Kanika Sharma MD, Naomi Ramer DMD, Ilana Ramer MD, Abib Agbetoba MD, Joelle Glick MD, Xinjie Yang MD, PhD, Delin Lei MD, Kristine Bjoerndal MD, PhD, Christian Godballe MD, PhD, Thomas Mücke MD, DDS, Wolff Klaus-Dietrich MD, DDS, PhD, André M. Eckardt MD, DDS, PhD, Chiara Copelli MD, Enrico Sesenna MD, Frank Palmer, Ian Ganly MD & Ziv Gil MD, PhD

  9. Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Hannover, Germany

    André M. Eckardt MD, DDS, PhD

  10. Maxillo-Facial Surgery, University-Hospital of Parma, Parma, Italy

    Chiara Copelli MD & Enrico Sesenna MD

  11. Head and Neck Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Frank Palmer & Ian Ganly MD

Authors
  1. Moran Amit MD
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  2. Shorook Na’ara MD
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  3. Kanika Sharma MD
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  4. Naomi Ramer DMD
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  5. Ilana Ramer MD
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  6. Abib Agbetoba MD
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  7. Joelle Glick MD
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  8. Xinjie Yang MD, PhD
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  9. Delin Lei MD
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  10. Kristine Bjoerndal MD, PhD
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  11. Christian Godballe MD, PhD
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  12. Thomas Mücke MD, DDS
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  13. Wolff Klaus-Dietrich MD, DDS, PhD
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  14. André M. Eckardt MD, DDS, PhD
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  15. Chiara Copelli MD
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  16. Enrico Sesenna MD
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  17. Frank Palmer
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  18. Ian Ganly MD
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  19. Ziv Gil MD, PhD
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Corresponding author

Correspondence to Ziv Gil MD, PhD.

Electronic supplementary material

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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)

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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Amit, M., Na’ara, S., Sharma, K. et al. Elective Neck Dissection in Patients With Head and Neck Adenoid Cystic Carcinoma: An International Collaborative Study. Ann Surg Oncol 22, 1353–1359 (2015). https://doi.org/10.1245/s10434-014-4106-7

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  • DOI: https://doi.org/10.1245/s10434-014-4106-7

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