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Eur J Cancer. 2020 Mar 11. pii: S0959-8049(20)30055-1. doi: 10.1016/j.ejca.2020.01.023. [Epub ahead of print]

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

Author information

1
Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 Rue de La Chine, 75020, Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France.
2
Department of Biopathology, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805, Villejuif, France.
3
Department of ENT-Head and Neck Surgery, University Hospital of Marseille, APHM, 13915, Marseille, France.
4
Department of Pathology, Lariboisière University Hospital, Paris Diderot University, APHP, 75010, Paris, France.
5
Department of Pathology and Cytopathology, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France.
6
Department of ENT-Head and Neck Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44000, Nantes, France.
7
Department of Pathology, Centre Antoine-Lacassagne, 31 avenue de Valombrose, 06189, Nice, France.
8
Department of Medical Oncology, Oncology Institute of Lorraine, Vandoeuvre-Lès-Nancy, 54035, Nancy, France.
9
Department of Maxillofacial Surgery, University Hospital of Amiens-Picardy, Avenue René Laennec, 80000, Amiens, France.
10
Department of Medical Oncology, Radiotherapy, Dermatology and Palliative Care, University Hospital of Saint André, 1 Rue Jean Burguet, 33075, Bordeaux, France.
11
Department of ENT-Head and Neck Surgery, University Hospital of Liège, Belgium.
12
Department of ENT-Head and Neck Surgery, Tours Bretonneau University Hospital, 2 Boulevard Tonnellé, 37000, Tours, France.
13
Department of Pathology, Hospital Bichat, APHP, 75018, Paris, France.
14
Department of Oral and Maxillofacial Surgery, Sorbonne University, Pitié-Salpêtrière Hospital, APHP, 75013, Paris, France.
15
Department of ENT-Head and Neck Surgery, Rennes University Hospital, 2 Rue Henri Le Guilloux, 35000, Rennes, France.
16
Department of Radiotherapy, François Baclesse Centre, 3 Rue Du Général Harris, 14000, Caen, France.
17
Department of Oncology Radiotherapy, Curie Institute, 26 Rue D'Ulm, 75005, Paris, France.
18
Department of ENT-Head and Neck Surgery, University Hospital of Strasbourg, 67000, Strasbourg, France.
19
Department of ENT-Head and Neck Surgery, Hospices Civils de Lyon, Lyon-Nord University Hospital, 103 Grande Rue de La Croix Rousse, 69000, Lyon, France.
20
Department of ENT-Head and Neck Surgery, University Hospital of Besançon, France, 25000, Besançon, France.
21
Department of ENT-Head and Neck Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble, France.
22
Department of Pathology, European Georges Pompidou University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris University, PARCC INSERM U970, Paris, France.
23
Department of Radiotherapy, Jean Perrin Centre, University Clermont Auvergne, 63100, Clermont-Ferrand, France.
24
Department of Pathology, University Hospital of Poitiers, 2 Rue de La Milétrie, CS 90577, 86021, POITIERS, France.
25
Department of ENT-Head and Neck Surgery, Rouen University Hospital, 1 Rue de Germont, 76031, Rouen, France.
26
Department of ENT-Head and Neck Surgery, Curie Institute, René Huguenin Hospital, Saint-Cloud, France.
27
Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100, Reims, France.
28
INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France.
29
Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 Rue de La Chine, 75020, Paris, France. Electronic address: bertrand.baujat@tnn.aphp.fr.

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; Event-free survival; Prognostic factors; REFCOR

PMID:
32171628
DOI:
10.1016/j.ejca.2020.01.023

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