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Adenoid cystic carcinoma of major and minor salivary gland origin
Author(s) -
Matsuba Howard M.,
Thawley Stanley E.,
Levine Laurence A.,
Simpson Joseph R.,
Mauney Marc
Publication year - 1984
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198410000-00011
Subject(s) - adenoid cystic carcinoma , salivary gland , minor salivary glands , carcinoma , medicine , pathology
The records of 76 patients with adenoid cystic carcinoma of major and minor salivary gland origin seen at the Washington University Medical Center from 1963‐1980 were reviewed to determine factors involved in local control, development of distant metastasis, and survival. Twenty‐four (32%) patients were initially treated with surgery alone, 36 (47%) with combined surgery and irradiation, and 16 (21%) with irradiation alone. Local control after treatment was determined for all patients and was analyzed with respect to extent of surgery and dose of irradiation. Of 75 patients evaluable for local control, 30 (40%) failed with a median time of less than 5 years. There was no significant difference for pntients treated vigorously for local recurrences after surgery. Patients who had a complete surgical resection ( i.e. , negative margins) survived significantly longer than patients treated by incomplete resection or biopsy alone followed by irradiation. Distant metastases developed in 50% of patients regardless of local control. Median survival after development of distant metastases was 40 months. There was no difference between major and minor gland sources for development of metastases. Lymph node involvement was rare. Our data indicate that complete and radical surgery results in the best survival. Combined modality therapy with surgery and irradiation optimizes the control of local disease. However, since distant metastases develop in spite of local control, in most instances we cannot recommend mutilating surgery for this disease entity.