Lung metastasis in adenoid cystic carcinoma of the head and neck

Head Neck. 2019 Nov;41(11):3976-3983. doi: 10.1002/hed.25942. Epub 2019 Aug 29.

Abstract

Background: Distant metastasis of adenoid cystic carcinoma (ACC) is most commonly identified in the lung, but risk factors are still on debate.

Methods: Risk factors for lung metastasis were evaluated by using Cox proportional hazards model and Kaplan-Meier curves.

Results: Of 112 patients, 48% had distant metastasis; 94.4% of whom had lung metastasis. Univariable analysis revealed sublingual or minor salivary gland, tumor size ≥2.5 cm, and perineural invasion as risk factors (hazard ratio [HR]: 1.99 [1.02-3.91], 2.57 [1.19-5.58], and 2.46 [1.28-4.74], respectively), whereas size, perineural invasion, and local recurrence were risk factors in multivariable analysis (HR: 2.29 [1.05-4.96], 2.32 [1.09-4.96], and 2.68 [1.24-5.79], respectively).

Conclusion: Sublingual gland or minor salivary glands ACC has a higher risk of lung metastasis. If the site is not considered, the following factors increased the risk of lung metastasis; (a) size ≥2.5 cm, (b) perineural invasion, and (c) local recurrence.

Keywords: head and neck neoplasm; neoplasm metastasis; risk factors; salivary glands.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Adenoid Cystic / secondary*
  • Female
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / secondary*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / epidemiology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Time Factors