Adenoid Cystic Carcinoma of the Head and Neck; Incidence and survival trends based on 1973-2007 SEER data Público
Ellington, Christopher Lee (2011)
Published
Abstract
Adenoid Cystic Carcinoma of the Head and Neck; Incidence and
survival trends based on
1973-2007 SEER Data
By Christopher L. Ellington
Introduction:
Adenoid Cystic Carcinoma (ACC) is a rare tumor of minor salivary,
parotid, and
submandibular glands. The biological behavior of the disease is
poorly understood, and
treatment strategies have yet to be standardized. The long-term
prognosis continues to
be poor, with an estimated 10-year survival of under 60%.
Population-based studies
examining ACC are scarce. We aimed to analyze incidence rates and
survival outcomes
for patients diagnosed ACC of the head and neck (ACCHN) using
national population-
based data.
Materials and Methods:
Data were obtained from the US National Cancer Institute's
Surveillance, Epidemiology,
and End Results (SEER) Program. Newly diagnosed ACCHN cases
reported to SEER
from 1973 through 2007 were categorized according to their sex,
race, age, year of
diagnosis, marital status, treatment interventions, primary tumor
site, and disease stage.
Incidence of ACCHN and post-diagnosis survival were examined over
time and
compared across different demographic and disease-related
categories.
Results:
We have identified 3026 patients with ACCHN between 1973 and 2007.
The mean age at
diagnosis among those cases was 57.4 years (range: 11-99 years).
Analyses of incidence
data demonstrated a decline in ACCHN rates between 1973 and 2007,
noted across all
sexes and races with no detectable inflexion points. The overall
5-year, 10-year, and 15-
year survival outcomes for ACCHN patients were 90.3%, 79.9%, and
69.2% respectively.
Females, patients with localized disease, and younger patients were
found to have
significantly better survival across all time periods (all
comparison-specific log rank p-
values <0.001). Multivariate analyses revealed better prognosis
among women
compared to men (hazard ratio [HR] = 0.72; 95% confidence interval
[CI]: 0.64-0.81),
among married compared to unmarried individuals (HR = 0.85; 95% CI:
0.75-0.97), and
in those who had surgery of the primary tumor site (HR = 0.50; 95%
CI: 0.42-0.61).
Conclusion:
The overall incidence of ACC seems to be on the decline. Survival
outcomes based on age
and stage of disease categories are consistent with clinical
literature on ACC. The noted
differences in survival based on gender, marital status, and
treatment intervention
require further investigation.
Table of Contents
Table of Contents
Introduction........................................................................................................................
1
Methods.............................................................................................................................
4
Results...............................................................................................................................
6
Discussion...........................................................................................................................
8
References..........................................................................................................................
10
Tables and Figures
...............................................................................................................
13
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