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Auris Nasus Larynx. 2016 Oct;43(5):477-84. doi: 10.1016/j.anl.2016.02.013. Epub 2016 Mar 24.

Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international review.

Author information

1
Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain; Fundación de Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain.
2
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
3
Departments of Surgery and Otolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
4
Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
5
Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
6
Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Cellular Pathology, Liverpool Clinical Laboratories, Liverpool, UK.
7
University of Udine School of Medicine, Udine, Italy.
8
Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
9
Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ, USA.
10
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.
11
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
12
Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal.
13
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
14
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
15
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
16
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
17
Department of Otolaryngology - Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, UK; European Salivary Gland Society, Geneva, Switzerland.
18
University Pathologists, Providence, RI, USA; University Pathologists, Fall River, MA, USA.
19
Department of Otolaryngology-Head and Neck Surgery, Philipp University, Marburg, Germany.
20
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
21
Department of Radiation Oncology, University of Florida, Gainesville, FL, USA.
22
Department of Otolaryngology - Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ, USA.
23
Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
24
Department of Pathology, Allegiance Health, Jackson, MI, USA.
25
Consultant Pathologist, Southern California Permanente Medical Group, Woodland Hills, CA, USA.
26
Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium.
27
Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
28
European Salivary Gland Society, Geneva, Switzerland; Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven and KU Leuven, Department of Oncology, Section Head and Neck Oncology, Leuven, Belgium.
29
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
30
Department of Pathology, Beth Israel Medical Center, New York, NY, USA.
31
Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzen, Plzen, Czech Republic.
32
Coordinator of the International Head and Neck Scientific Group. Electronic address: a.ferlito@uniud.it.

Abstract

The purpose of this study was to suggest general guidelines in the management of the N0 neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not related to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation.

KEYWORDS:

Adenoid cystic; Carcinoma; Lymph nodes; Neck dissection; Recurrence; Risk factors

PMID:
27017314
PMCID:
PMC5193158
DOI:
10.1016/j.anl.2016.02.013
[Indexed for MEDLINE]
Free PMC Article

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