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Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances

SIMPLE SUMMARY: Acinic cell carcinoma (AciCC) is a rare subtype of salivary gland neoplasm accounting for 6–7% of such tumors. In our study, we analyzed 2226 total cases of AciCC while conducting analysis on the demographic trends and outcomes related to different treatment strategies, clinical char...

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Autores principales: Khan, Jaffar, Ullah, Asad, Goodbee, Mya, Lee, Kue Tylor, Yasinzai, Abdul Qahar Khan, Lewis, James S., Mesa, Hector
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10340722/
https://www.ncbi.nlm.nih.gov/pubmed/37444484
http://dx.doi.org/10.3390/cancers15133373
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author Khan, Jaffar
Ullah, Asad
Goodbee, Mya
Lee, Kue Tylor
Yasinzai, Abdul Qahar Khan
Lewis, James S.
Mesa, Hector
author_facet Khan, Jaffar
Ullah, Asad
Goodbee, Mya
Lee, Kue Tylor
Yasinzai, Abdul Qahar Khan
Lewis, James S.
Mesa, Hector
author_sort Khan, Jaffar
collection PubMed
description SIMPLE SUMMARY: Acinic cell carcinoma (AciCC) is a rare subtype of salivary gland neoplasm accounting for 6–7% of such tumors. In our study, we analyzed 2226 total cases of AciCC while conducting analysis on the demographic trends and outcomes related to different treatment strategies, clinical characteristics, and other demographics. AciCC mainly affected white females in their 50s. Grade III (poorly differentiated) and Grade IV (undifferentiated) cancers along with tumors that metastasized were associated with worse survival outcomes. This study aims to provide further data on treatment strategies, demographic features and trends, and factors associated with poorer prognosis. ABSTRACT: Background: Acinic cell carcinoma (AciCC) comprises 6–7% of all salivary gland neoplasms and is the second most common salivary gland malignancy in children. Like many salivary gland carcinomas, it is considered low grade but occasionally it behaves aggressively. Understanding the risk factors associated with recurrence, metastasis, and death is important to determine the counseling and management of individual patients. Older population-based studies are presumed to have been confounded by the misclassification of other neoplasms as AciCC, in particular secretory carcinoma and cystadenocarcinoma. Since diagnostic tools to reliably separate these entities have been available for over a decade, reevaluation of epidemiologic data limited to the 21st century should allow a better characterization of the clinicopathological characteristics of AciCC. Methods: Our study extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2018. Cox regression model analysis was performed to identify risk factors independently affecting survival. Results: Data for 2226 patients with AciCC were extracted from the database. Most patients were females: 59%, and white: 80.5%, with a mean age at diagnosis of 51.2 (SD ± 18.7) years. Most cases (81%) were localized at presentation. Tumor size was less than 2 cm in 42%, 2–4 cm in 47%, and >4 cm in 11%. Low-grade tumors had 5-year survival > 90%, whereas high-grade tumors had survival < 50%. Of the patients with known lymph node status only 7.3% had nodal metastases. Distant metastases were documented in 1.1%, involving lungs 44%, bone 40%, liver 12%, and brain 4%. The most common treatment modality was surgery alone: 63.6% followed by surgery and adjuvant radiation: 33%. A few received chemotherapy (1.8%) or multimodality therapy (1.2%). The 5-year overall survival rate was 90.6% (95%CI 89.1–91.9), and disease-specific survival was 94.6% (95%CI 93.3–95.6). Multivariable cox regression analysis showed that undifferentiated (HR = 8.3) and poorly differentiated tumor grade (HR = 6.4), and metastasis (HR = 5.3) were the worst independent prognostic factors. Other poor risk factors included age > 50 (HR = 3.5) and tumor size > 4 cm (HR = 2.5). Conclusions: In the US, AciCC is more common in middle age white females, and most tumors are less than 4 cm and localized at diagnosis. The most relevant negative prognostic factor was high tumor grade which was associated with higher hazard ratios for death than all other variables, including regional or distant metastases at presentation.
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spelling pubmed-103407222023-07-14 Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances Khan, Jaffar Ullah, Asad Goodbee, Mya Lee, Kue Tylor Yasinzai, Abdul Qahar Khan Lewis, James S. Mesa, Hector Cancers (Basel) Article SIMPLE SUMMARY: Acinic cell carcinoma (AciCC) is a rare subtype of salivary gland neoplasm accounting for 6–7% of such tumors. In our study, we analyzed 2226 total cases of AciCC while conducting analysis on the demographic trends and outcomes related to different treatment strategies, clinical characteristics, and other demographics. AciCC mainly affected white females in their 50s. Grade III (poorly differentiated) and Grade IV (undifferentiated) cancers along with tumors that metastasized were associated with worse survival outcomes. This study aims to provide further data on treatment strategies, demographic features and trends, and factors associated with poorer prognosis. ABSTRACT: Background: Acinic cell carcinoma (AciCC) comprises 6–7% of all salivary gland neoplasms and is the second most common salivary gland malignancy in children. Like many salivary gland carcinomas, it is considered low grade but occasionally it behaves aggressively. Understanding the risk factors associated with recurrence, metastasis, and death is important to determine the counseling and management of individual patients. Older population-based studies are presumed to have been confounded by the misclassification of other neoplasms as AciCC, in particular secretory carcinoma and cystadenocarcinoma. Since diagnostic tools to reliably separate these entities have been available for over a decade, reevaluation of epidemiologic data limited to the 21st century should allow a better characterization of the clinicopathological characteristics of AciCC. Methods: Our study extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2018. Cox regression model analysis was performed to identify risk factors independently affecting survival. Results: Data for 2226 patients with AciCC were extracted from the database. Most patients were females: 59%, and white: 80.5%, with a mean age at diagnosis of 51.2 (SD ± 18.7) years. Most cases (81%) were localized at presentation. Tumor size was less than 2 cm in 42%, 2–4 cm in 47%, and >4 cm in 11%. Low-grade tumors had 5-year survival > 90%, whereas high-grade tumors had survival < 50%. Of the patients with known lymph node status only 7.3% had nodal metastases. Distant metastases were documented in 1.1%, involving lungs 44%, bone 40%, liver 12%, and brain 4%. The most common treatment modality was surgery alone: 63.6% followed by surgery and adjuvant radiation: 33%. A few received chemotherapy (1.8%) or multimodality therapy (1.2%). The 5-year overall survival rate was 90.6% (95%CI 89.1–91.9), and disease-specific survival was 94.6% (95%CI 93.3–95.6). Multivariable cox regression analysis showed that undifferentiated (HR = 8.3) and poorly differentiated tumor grade (HR = 6.4), and metastasis (HR = 5.3) were the worst independent prognostic factors. Other poor risk factors included age > 50 (HR = 3.5) and tumor size > 4 cm (HR = 2.5). Conclusions: In the US, AciCC is more common in middle age white females, and most tumors are less than 4 cm and localized at diagnosis. The most relevant negative prognostic factor was high tumor grade which was associated with higher hazard ratios for death than all other variables, including regional or distant metastases at presentation. MDPI 2023-06-27 /pmc/articles/PMC10340722/ /pubmed/37444484 http://dx.doi.org/10.3390/cancers15133373 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Khan, Jaffar
Ullah, Asad
Goodbee, Mya
Lee, Kue Tylor
Yasinzai, Abdul Qahar Khan
Lewis, James S.
Mesa, Hector
Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
title Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
title_full Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
title_fullStr Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
title_full_unstemmed Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
title_short Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
title_sort acinic cell carcinoma in the 21st century: a population-based study from the seer database and review of recent molecular genetic advances
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10340722/
https://www.ncbi.nlm.nih.gov/pubmed/37444484
http://dx.doi.org/10.3390/cancers15133373
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