Adenoid cystic carcinoma (ACC) is a rare epithelial tumor with a
distinct natural history characterized by an indolent but persistent
growth, late onset of distant metastases and eventual death of patients.
Between 1991 and 2003, 23 patients with ACC were treated in our
Department. Surgery with a curative intent followed by radiotherapy (RT)
was applied in 22 patients. Complete resection was achieved in 72.73%
of patients. Local recurrence occurred in 26% of patients. Positive
margins emerged as the only statistically significant parameter (p <
0.0001) influencing the development of local recurrence. Distant
metastasis (DM) occurred in 47.8% of patients. In 54.5% of the
patients developing DM, this occurred between 5 and 10 years after the
initial treatment. DM was influenced by perineural invasion (p = 0.04)
and was disassociated from local control of the tumor. The mean overall
survival of our patients was 70.58 months and the mean disease free
survival 61.85 months. Perineural invasion (p = 0.048) and DM (p =
0.001) had a statistically significant impact on final patients’
outcome.
The most important factor influencing survival was DM. Its late onset,
irrespectively of local control, supports the hypothesis that ACC has a
potential to develop DM in the very early phases of tumor growth. (c)
2005 Elsevier Ltd. All rights reserved
