The seventh decade of life was the age at which patients were most commonly affected and it accounted for 31.8% of the 66 cases of adenoid cystic carcinoma studied. There were 31 male and 35 female cases. In most patients (43. 2%) a mass without pain was the main complaint.
Of the 66 tumors, 27 (40.9%) occurred in the minor salivary gland. Twenty tumors (30.3%) were found in the major salivary gland, 13 (19.7%) in the airways, and 6 (9.1%) in miscellaneous sites.
The proliferative degree of adenoid cystic carcinomas correlated with the histologic grade and with the prognosis. Grade ill tumors tended to have a higher proliferative degree, and patients with a lower proliferative degree tended to have a better prognosis.
Patients with tumors in the major and minor salivary gland had a good prognosis, with cumulative 10-year survival rates being 31. 6%, and 37. 3% respectively. These rates were better than that in patients with tumors in the airways, who had a cumulative survival rate of 15%,
Recurrence rate in the 53 cases treated by surgery was 71.7%, and that in the caseswith bone invasion by the tumor was 90.0%, However, in case without bone invasion the recurrence rate was 60.6%.
The patients treated by a combination of surgery and radiation therapy had a better prognosis than the patients treated by other therapies, but the difference was not significant.
Comulative survival rates of the 61 patients at 3, 5, 10, and 15 years were 80.8%, 65.0%, 37.2%, and 37.2%, respectively.
The 5-year cumulative survival rates were 81.8%, 73.6%, 25.6%, and the 10-year cumulative survival rates were 68.2%, 38.9%, and 0.0%, for histological Grades I, II, and III, respectively. A high histological grade tended to be associated with a poor prognosis.
More than one cell in mitosis per high power field (×400) was found to be a sign of a poor prognosis.
The presence of vascular invasion was correlated with the metastatic rate, but the presence of perineural invasion was not correlated with recurrence or metastasis.
The clinicopathological malignant score (minimum: score 3, maximum: score 9) assessed based on three factors (clinical staging, histological grading, number of mototic cells) in this study was correlated with the prognosis of adenoid cystic carcinoma.
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