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Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis

SIMPLE SUMMARY: Adenoid cystic carcinoma (ACC) is a rare but lethal salivary gland tumor, comprising less than 1% of head and neck neoplasms. It can affect several sites in the head and neck region, but the potential role of tumor site on survival and treatment response remains unclear and, to this...

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Autores principales: Tasoulas, Jason, Divaris, Kimon, Theocharis, Stamatios, Farquhar, Douglas, Shen, Colette, Hackman, Trevor, Amelio, Antonio L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913220/
https://www.ncbi.nlm.nih.gov/pubmed/33546179
http://dx.doi.org/10.3390/cancers13040589
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author Tasoulas, Jason
Divaris, Kimon
Theocharis, Stamatios
Farquhar, Douglas
Shen, Colette
Hackman, Trevor
Amelio, Antonio L.
author_facet Tasoulas, Jason
Divaris, Kimon
Theocharis, Stamatios
Farquhar, Douglas
Shen, Colette
Hackman, Trevor
Amelio, Antonio L.
author_sort Tasoulas, Jason
collection PubMed
description SIMPLE SUMMARY: Adenoid cystic carcinoma (ACC) is a rare but lethal salivary gland tumor, comprising less than 1% of head and neck neoplasms. It can affect several sites in the head and neck region, but the potential role of tumor site on survival and treatment response remains unclear and, to this day, the role that tumor location plays in treatment planning and survival has not been considered. We sought to address these knowledge gaps via analyses of the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis identified that patients with submandibular gland adenoid cystic carcinomas, particularly those with late-stage disease, had worse survival compared to other sites and benefited the most from adjuvant radiotherapy. In contrast, early-stage and non-submandibular adenoid cystic carcinoma patients showed no survival benefit from adjuvant radiotherapy (aRT). These results underscore the role of tumor site on treatment response and survival of patients with head and neck ACC. ABSTRACT: Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor, displaying aggressive behavior with frequent recurrence and metastasis. Little information exists regarding the impact of clinicopathological parameters and adjuvant radiotherapy (aRT) on ACC disease specific (DSS) and overall survival (OS). We extracted demographic, treatment, and survival information of 1439 patients with major or minor intraoral salivary gland ACC from the Surveillance, Epidemiology, and End Results (SEER) database. The associations between tumor characteristics and aRT with OS and DSS were estimated using hazard ratios (HR) and 95% confidence intervals (CI). Submandibular gland ACCs had the worst prognosis (adjusted DSS HR = 1.48; 95% CI = 0.99–2.20, compared to parotid), and this difference was more pronounced among patients with advanced-stage tumors (adjusted DSS HR = 1.93; 95% CI = 1.13–3.30). aRT was associated with increased overall survival only among stage III submandibular ACC patients (HR = 0.64; 95% CI = 0.42–0.98) and had no benefit in any other group. In conclusion, submandibular gland ACC carries a worse prognosis than other gland subsites and may benefit from aRT. The different outcomes between submandibular gland and other major or minor gland ACCs warrant further mechanistic investigation.
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spelling pubmed-79132202021-02-28 Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis Tasoulas, Jason Divaris, Kimon Theocharis, Stamatios Farquhar, Douglas Shen, Colette Hackman, Trevor Amelio, Antonio L. Cancers (Basel) Article SIMPLE SUMMARY: Adenoid cystic carcinoma (ACC) is a rare but lethal salivary gland tumor, comprising less than 1% of head and neck neoplasms. It can affect several sites in the head and neck region, but the potential role of tumor site on survival and treatment response remains unclear and, to this day, the role that tumor location plays in treatment planning and survival has not been considered. We sought to address these knowledge gaps via analyses of the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis identified that patients with submandibular gland adenoid cystic carcinomas, particularly those with late-stage disease, had worse survival compared to other sites and benefited the most from adjuvant radiotherapy. In contrast, early-stage and non-submandibular adenoid cystic carcinoma patients showed no survival benefit from adjuvant radiotherapy (aRT). These results underscore the role of tumor site on treatment response and survival of patients with head and neck ACC. ABSTRACT: Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor, displaying aggressive behavior with frequent recurrence and metastasis. Little information exists regarding the impact of clinicopathological parameters and adjuvant radiotherapy (aRT) on ACC disease specific (DSS) and overall survival (OS). We extracted demographic, treatment, and survival information of 1439 patients with major or minor intraoral salivary gland ACC from the Surveillance, Epidemiology, and End Results (SEER) database. The associations between tumor characteristics and aRT with OS and DSS were estimated using hazard ratios (HR) and 95% confidence intervals (CI). Submandibular gland ACCs had the worst prognosis (adjusted DSS HR = 1.48; 95% CI = 0.99–2.20, compared to parotid), and this difference was more pronounced among patients with advanced-stage tumors (adjusted DSS HR = 1.93; 95% CI = 1.13–3.30). aRT was associated with increased overall survival only among stage III submandibular ACC patients (HR = 0.64; 95% CI = 0.42–0.98) and had no benefit in any other group. In conclusion, submandibular gland ACC carries a worse prognosis than other gland subsites and may benefit from aRT. The different outcomes between submandibular gland and other major or minor gland ACCs warrant further mechanistic investigation. MDPI 2021-02-03 /pmc/articles/PMC7913220/ /pubmed/33546179 http://dx.doi.org/10.3390/cancers13040589 Text en © 2021 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tasoulas, Jason
Divaris, Kimon
Theocharis, Stamatios
Farquhar, Douglas
Shen, Colette
Hackman, Trevor
Amelio, Antonio L.
Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis
title Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis
title_full Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis
title_fullStr Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis
title_full_unstemmed Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis
title_short Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis
title_sort impact of tumor site and adjuvant radiotherapy on survival of patients with adenoid cystic carcinoma: a seer database analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913220/
https://www.ncbi.nlm.nih.gov/pubmed/33546179
http://dx.doi.org/10.3390/cancers13040589
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