A prospective multicentre REFCOR study of 470 cases of head and neck Adenoid cystic carcinoma: epidemiology and prognostic factors: Adenoid cystic carcinoma (ACC) accounts for 1% of malignant head and neck tumours [1] and 10% of salivary glands malignant tumours. The main objective of our study is to investigate the prognostic factors influencing the event-free survival (EFS) of patients with ACC.

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A prospective multicentre REFCOR study of 470 cases of head and neck Adenoid cystic carcinoma: epidemiology and prognostic factors

Sarah Atallaha,b

, 

Odile Casiraghic

, 

Nicolas Fakhryd

, 

Michel Wassefe

, 

Emmanuelle Uro-Costef

, 

Florent Espitalierg

, 

Anne Sudakah

, 

Marie Christine Kaminskyi

, 

Stéphanie Dakpej

, 

Laurence Diguek

, 

Olivier Bouchainl

, 

Sylvain Morinièrem

, 

Muriel Hourseaun

, 

Chloé Bertoluso

, 

Franck Jegouxp

, 

Juliette Thariatq

, 

Valentin Calugarur

, 

Philippe Schultzs

, 

Pierre Philouzet

, 

Olivier Mauvaisu

, 

Christian A. Righiniv

, 

Cécile Badoualw

, 

Nicolas Saroulx

, 

Jean Michel Goujony

, 

Jean Paul Mariez

, 

Rabah Taouachiaa

, 

Esteban Brenetab

, 

Anne Aupérinac

, 

Bertrand Baujata,∗,Correspondence information about the author Bertrand BaujatEmail the author Bertrand Baujat

DOI: https://doi.org/10.1016/j.ejca.2020.01.023

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Highlights

• •Head and neck adenoid cystic carcinoma occur more frequently in women (sex ratio: 1.5).
• •Age, body mass index and N stage are the three main clinical prognostic factors influencing event-free survival.
• •Tumour size, perineural invasion and the presence of histological grade III also have a negative influence on prognosis.

Abstract

Background

Adenoid cystic carcinoma (ACC) accounts for 1% of malignant head and neck tumours [1] and 10% of salivary glands malignant tumours. The main objective of our study is to investigate the prognostic factors influencing the event-free survival (EFS) of patients with ACC.

Patients and methods

A multicentre prospective study was conducted from 2009 to 2018. All 470 patients with ACC whose survival data appear in the REFCOR database were included in the study. The main judgement criterion was EFS. Both a bivariate survival analysis using log-rank test and a multivariate using Cox model were performed using the R software.

Results

Average age was 55 years. Females accounted for 59.4% of the cohort. The body mass index (BMI) was normal in 86% of cases. Tumours were located in minor salivary glands in 60% of cases. T3/T4 stages represented 58%; 89% of patients were cN0. histological grade III was observed on 21% of patients. The EFS and overall 5-year survival rates were 50% and 85%, respectively. After adjustment, the most significant pejorative prognostic factors were age ≥65 years (hazard ratio [HR] = 1.67), BMI<16.5 (HR = 2.62), and lymph node invasion cN (HR = 2.08).

Conclusion

Age, BMI and N stage are the three main clinical prognostic factors determining EFS identified in this prospective series of patients with ACC. Such findings open new research perspectives on the influence of these components on initial patient care.

Keywords:

Adenoid cystic carcinoma, Prognostic factors, Event-free survival, REFCOR