BACKGROUND Adenoid cystic carcinoma (ACC) is a locally aggressive tumor with a high prevalence of distant metastases. The current study aimed to identify independent predictors of outcome and to characterize the patterns of failure. METHODS: An international retrospective review of 489 ACC patients treated between 1985 and 2011 in 9 cancer centers worldwide. RESULTS: Five-year overall-survival (OS), disease-specific survival(DSS) and disease-free survival (DFS) were 76%, 80% and 68%, respectively. Independent predictors of OS and DSS were: age, site, N classification and presence of distant metastases(DM). N stage, age and bone invasion were associated with DFS on multivariate analysis. Age, tumor site, orbital invasion and N stage were independent predictors of DM. CONCLUSION: The clinical course of ACC is slow but persistent. Paranasal sinus origin is associated with the lowest distant metastasis rate but with the poorest outcome. These prognostic estimates should be considered when tailoring treatment for patients with ACC. Head Neck, 2013.
Head and Neck (print Edition), 2014, Vol 36, Issue 7, p. 998-1004