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Klein Nulent TJW, van Es RJJ, Breimer GE, Valstar MH, Smit LA, Speksnijder CM, de Bree R, Willems SM. MYB immunohistochemistry as a predictor of MYB::NFIB fusion in the diagnosis of adenoid cystic carcinoma of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00433-4. [PMID: 39218775 DOI: 10.1016/j.oooo.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/02/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES Diagnosing adenoid cystic carcinoma (AdCC) is challenging due to histopathological variability and similarities with other tumors. In AdCC pathogenesis, the cellular myeloblastosis gene (c-MYB) often exhibits a MYB::NFIB fusion from a reciprocal translocation. This study aimed to assess the predictive accuracy of MYB immunohistochemistry for detecting this translocation compared to fluorescence in situ hybridization (FISH). STUDY DESIGN This study included 110 AdCC patients (1999-2017) from two Dutch head and neck centers using tissue microarrays and full slides. Median MYB expression levels by immunohistochemistry were compared based on translocation status by FISH, and differences within clinicopathological parameters were examined. An immunohistochemical cut-off was established to estimate the translocation. RESULTS MYB immunohistochemistry was available in 90/110 patients, with a median expression of 27%. FISH was interpretable in 79/108 tumors, identifying MYB::NFIB fusion in 44 (56%). Among 62 patients with both MYB expression and translocation data, the fusion was present in 38 (61%). These tumors had higher MYB expression (30%) than nontranslocated tumors (6%); P = .02. A 60% MYB expression cut-off yielded 100% specificity for detecting the translocation but had no prognostic value. CONCLUSIONS Although MYB protein expression alone lacks diagnostic precision, protein expression >60% predicted the MYB::NFIB fusion in all tumors.
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Affiliation(s)
- Thomas J W Klein Nulent
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, Haaglanden Medical Center, The Hague, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Robert J J van Es
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerben E Breimer
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthijs H Valstar
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Laura A Smit
- Department of Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Caroline M Speksnijder
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
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2
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Wu WB, Cai WL, Zou YH, You R, Liu YP, Yuan ZD, Li Q, Li WC, Pi ZX, Xie YL, Wen K, Chen MY, Sun R. Outcomes of patients in nasopharyngeal adenoid cystic carcinoma in the IMRT era: a single-center experience. BMC Cancer 2024; 24:576. [PMID: 38730348 PMCID: PMC11084105 DOI: 10.1186/s12885-024-12159-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 03/21/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with special biological features. Controversies exist regarding the treatment approach and prognostic factors in the IMRT era. This study aimed to evaluate the long-term outcomes and management approaches in NACC. METHODS Fifty patients with NACC at our institution between 2010 and 2020 were reviewed. Sixteen patients received primary radiotherapy (RT), and 34 patients underwent primary surgery. RESULTS Between January 2010 and October 2020, a total of 50 patients with pathologically proven NACC were included in our analysis. The median follow-up time was 58.5 months (range: 6.0-151.0 months). The 5-year overall survival rate (OS) and progression-free survival rate (PFS) were 83.9% and 67.5%, respectively. The 5-year OS rates of patients whose primary treatment was surgery and RT were 90.0% and 67.3%, respectively (log-rank P = 0.028). The 5-year PFS rates of patients whose primary treatment was surgery or RT were 80.8% and 40.7%, respectively (log-rank P = 0.024). Multivariate analyses showed that nerve invasion and the pattern of primary treatment were independent factors associated with PFS. CONCLUSIONS Due to the relative insensitivity to radiation, primary surgery seemed to provide a better chance of disease control and improved survival in NACC. Meanwhile, postoperative radiotherapy should be performed for advanced stage or residual tumours. Cranial nerve invasion and treatment pattern might be important factors affecting the prognosis of patients with NACC.
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Affiliation(s)
- Wen-Bin Wu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Wu-Lin Cai
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Ye-Hao Zou
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Rui You
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - You-Ping Liu
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Zhao-Di Yuan
- Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510060, China
| | - Qiong Li
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Wen-Chao Li
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Zhi-Xuan Pi
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Yu-Long Xie
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Kai Wen
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Ming-Yuan Chen
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China.
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
| | - Rui Sun
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, P.R. China.
- Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
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Noronha MSD, Viana KSS, Aguiar MCFD, Squarize CH, Abreu MHNGD, Mendonça EF, Bernardes VDF. EZH2 immunoexpression in pleomorphic adenoma and adenoid cystic carcinoma and clinicopathological features. Braz Oral Res 2024; 38:e018. [PMID: 38477804 PMCID: PMC11376654 DOI: 10.1590/1807-3107bor-2024.vol38.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/03/2023] [Indexed: 03/14/2024] Open
Abstract
The aim of this study was to evaluate the expression of the EZH2 protein and describe the clinical and microscopic characteristics of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA). The study included 16 ACC cases and 12 PA. All ACC and PA cases were positive for EZH2 and the ACC samples showed significantly higher EZH2 expression. The clinical and microscopic covariates were described in relation to EZH2 staining in ACC samples. The highest mean values of EZH2 were observed in cases with local metastasis, recurrence, perineural invasion, and predominantly cribriform growth pattern without solid areas. EZH2 is a potential marker of malignancy.
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Affiliation(s)
- Mariana Saturnino de Noronha
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Karolina Skarlet Silva Viana
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Maria Cássia Ferreira de Aguiar
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Cristiane Helena Squarize
- University of Michigan, School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, USA
| | | | - Elismauro Francisco Mendonça
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Sciences, Goiânia, GO, Brazil
| | - Vanessa de Fátima Bernardes
- Universidade Federal de Minas Gerais - UFMG, Biological Sciences Institute, Department of Pathology, Belo Horizonte, MG, Brazil
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Alsarraj M, Alshehri SM, Qattan A, Mofti A, Wazqer L, Bukhari S, Shamsaldin A, Rajab R. Lymph Node Involvement and the Clinical Stage as Predictors of the Survival of Patients With Adenoid Cystic Carcinoma of the Head and Neck: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e30780. [DOI: 10.7759/cureus.30780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
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5
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Elhamid S, Razem B, Slimani F. Extraglandular orbital adenoid cystic carcinoma. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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6
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Does total parotidectomy improve survival over partial parotidectomy in early stage adenoid cystic carcinoma of the parotid gland? J Oral Maxillofac Surg 2022; 80:1550-1556. [DOI: 10.1016/j.joms.2022.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 01/03/2023]
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7
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Comparison of Clinical Outcomes of Definitive and Postoperative Radiotherapy for Adenoid Cystic Carcinoma of the Head and Neck: Can Definitive Radiotherapy Be a Treatment Option? Cancers (Basel) 2021; 13:cancers13215507. [PMID: 34771670 PMCID: PMC8582871 DOI: 10.3390/cancers13215507] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/27/2021] [Accepted: 10/30/2021] [Indexed: 11/27/2022] Open
Abstract
Simple Summary Adenoid cystic carcinoma of the head and neck is a rare malignant tumor; thus, it is difficult to establish an optimal treatment based on clinical trials with a large number of enrolled patients. Retrospective analyses of a small number of cases have revealed that the standard treatment is surgical resection followed by postoperative radiotherapy, while definitive radiotherapy is considered inadequate. Previous studies have used classical techniques for radiotherapy and did not evaluate the efficacy of current radiotherapy techniques, which may have underestimated the efficacy of definitive radiotherapy. We retrospectively analyzed 44 cases of adenoid cystic carcinoma of the head and neck treated with current radiotherapy techniques. Our results show that definitive radiotherapy is comparable to surgical resection followed by postoperative radiotherapy with respect to overall survival and local control. The results suggest that definitive radiotherapy can be an effective treatment option for adenoid cystic carcinoma of the head and neck. Abstract Background: The standard treatment for adenoid cystic carcinoma of the head and neck is surgical resection followed by postoperative radiotherapy (PORT). Currently, definitive radiotherapy (defRT) is considered an inadequate treatment; however, its data are based on studies using classical radiotherapy techniques. Therefore, the therapeutic effects of current radiotherapy techniques have not been adequately evaluated, and it may have underestimated the efficacy of defRT. Methods: We retrospectively analyzed 44 adenoid cystic carcinoma patients treated with radiotherapy based on modern treatment techniques from 1993 to 2017. Results: Twenty-four patients underwent PORT and 20 patients underwent defRT. The 5-year overall survival rates for patients treated with PORT and defRT were 85.3% and 79.7%, respectively. The 5-year local control rates were 82.5% and 83.1%, respectively. There were no statistically significant differences in the overall survival and local control of patients treated with PORT and defRT (p = 0.4392 and p = 0.0904, respectively). Conclusion: Our results show that defRT is comparable to surgical resection followed by PORT with respect to overall survival and local control. The results suggest that defRT can be an effective treatment option for adenoid cystic carcinoma of the head and neck.
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8
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Quantitative ubiquitylomics reveals the ubiquitination regulation landscape in oral adenoid cystic carcinoma. Biosci Rep 2021; 41:229447. [PMID: 34350460 PMCID: PMC8385350 DOI: 10.1042/bsr20211532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/04/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is an extremely rare salivary gland tumor with a poor prognosis and needs attention on molecular mechanisms. Protein ubiquitination is an evolutionarily conserved post-translational modification (PTM) for substrates degradation and controls diverse cellular functions. The broad cellular function of ubiquitination network holds great promise to detect potential targets and identify respective receptors. Novel technologies are discovered for in-depth research and characterization of the precise and dynamic regulation of ubiquitylomics in multiple cellular processes during cancer initiation, progression and treatment. In the present study, 4D label-free quantitative techniques of ubiquitination proteomics were used and we identified a total of 4152 ubiquitination sites in 1993 proteins. We also performed a systematic bioinformatics analysis for differential modified proteins and peptides containing quantitative information through the comparation between oral ACC (OACC) tumor with adjacent normal tissues, as well as the identification of eight protein clusters with motif analysis. Our findings offered an important reference of potential biomarkers and effective therapeutic targets for ACC.
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9
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Takayama K, Kato T, Nakamura T, Azami Y, Ono T, Suzuki M, Takada A, Yamaguchi H, Seto I, Nakasato T, Wada H, Kikuchi Y, Mitsudo K, Fuwa N, Murakami M. Proton beam therapy combined with intra-arterial infusion chemotherapy for stage Ⅳ adenoid cystic carcinoma of the base of the tongue. TOUKEIBU GAN 2021; 47:21-29. [DOI: 10.5981/jjhnc.47.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Affiliation(s)
- Kanako Takayama
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
| | - Takahiro Kato
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Yusuke Azami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Takashi Ono
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | | | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Ichiro Seto
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | | | - Hitoshi Wada
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital
| | - Masao Murakami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
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Romano A, Lo Faro C, Iaconetta G, Committeri U, Audino G, Salzano G, Maglitto F, Califano L, Dell'aversana Orabona G. Adenoid cystic carcinoma of accessory parotid gland: A case report and review of the literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Bastian T, D'Heygere V, Deuß E, Lax H, Wittig A, Sauerwein W, Arweiler-Harbeck D. [Results of surgical and radiotherapeutic treatment of adenoid cystic carcinoma of the salivary glands]. HNO 2020; 68:678-687. [PMID: 32821981 DOI: 10.1007/s00106-020-00913-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Surgical treatment in patients with rare adenoid cystic carcinoma (ACC) of the salivary glands is considered to be the state of the art. With respect to an additional radiotherapy there are different approaches regarding the type of radiotherapy and timing. In this study the overall survival and recurrence-free survival in 52 individuals with salivary gland ACC who were treated at the University Hospital in Essen and received irradiation with fast neutrons and photons (mixed beam technique) either A) immediately following surgical treatment or B) only after the appearance of local recurrence were compared. Group A (n = 28, first diagnosis, FD September 1991-September 2009) received adjuvant radiotherapy immediately postoperative, group B (n = 24, FD June 1979-November 2001) underwent primarily surgical tumor resection according to the treatment regimen at that time and were irradiated only on the appearance of a local recurrence. In comparison to group B, patients in group A showed a lower recurrence rate and a significantly longer local relapse-free survival. Group B, however, showed a significantly higher overall survival. The frequency of distant metastasis occurred equally in both groups but the onset of distant metastasis was significantly earlier in group A. In general, overall survival was negatively influenced by distant metastasis. The local recurrence rate was very high after primary surgical treatment only. The immediate adjuvant high-linear energy transfer (LET) radiotherapy reduced the local recurrence rates. Irradiation after the appearance of a recurrence had a positive influence on overall survival. Overall, definitive high-LET radiotherapy in the mixed beam technique enabled high local control rates both primarily postoperative and also locoregional recurrences.
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Affiliation(s)
- T Bastian
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - V D'Heygere
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - E Deuß
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - H Lax
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - A Wittig
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Jena, Deutschland
| | - W Sauerwein
- Klinik für Strahlentherapie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - D Arweiler-Harbeck
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
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12
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Mu X, Li Y, He L, Guan H, Wang J, Wei Z, He Y, Liu Z, Li R, Peng X. Prognostic nomogram for adenoid cystic carcinoma in different anatomic sites. Head Neck 2020; 43:48-59. [PMID: 32864833 DOI: 10.1002/hed.26443] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/13/2020] [Accepted: 08/14/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xiaoli Mu
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Yan Li
- Department of Head and Neck, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Ling He
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Hui Guan
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Jingjing Wang
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Zhigong Wei
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Yan He
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Zheran Liu
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Ruidan Li
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu China
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13
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Sun M, Qu Y, Wang K, Wu R, Zhang Y, Zhang S, Xiao J, Yi J, Gao L, Xu G, Huang X, Luo J. Long-term outcomes of patients in different histological subtypes of primary nasopharyngeal adenocarcinoma: A single-center experience with 71 cases. Oral Oncol 2020; 111:104923. [PMID: 32795912 DOI: 10.1016/j.oraloncology.2020.104923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/17/2020] [Accepted: 07/19/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study is aimed to evaluate the long-term outcomes and management approaches in different histological subtypes of primary nasopharyngeal adenocarcinoma (NPAC). MATERIALS AND METHODS 71 patients with NPAC at our institution between 1984 and 2016 were reviewed, including adenoid cystic carcinoma (ACC) in 43 patients, mucoepidermoid carcinoma (MEC) in 17 patients, and primary traditional adenocarcinoma (AC) in 11 patients. 37 patients received primary radiotherapy and 34 patients underwent primary surgery. RESULTS The median time of follow-up was 77 months. The 5-year overall survival rate (OS), locoregional failure-free survival rate (LRFFS) and distant metastasis failure-free survival rate (DFFS) were 69.9%, 67.1% and 77.9%, respectively. Patients who received combined modality therapy had better 5-year OS (73.7% vs 66.2%, p = 0.065) and LRFFS (73.1% vs 64.5%, p = 0.047) than patients receiving single modality therapy. Regarding the different histological subtypes, the survival rates of patients with ACC undergoing primary radiotherapy and primary surgery were similar (5-year OS 82.3% vs 68.8%, LRFFS 70.0% vs 70.8%, p>0.05). As to patients with MEC and AC, those who underwent primary surgery achieved better 5-year OS (75.6% vs 45.5%, p = 0.001) and LRFFS (70.6%% vs 57.1%, p = 0.014) than those who received primary radiotherapy. Multivariate analyses indicated that histological subtypes and radiotherapy technique were independent factors for OS. CONCLUSIONS The optimal treatment policy for NPAC remained the combination of radiotherapy and surgery. For patients with ACC, radiotherapy could be considered as the primary treatment. Surgery was suggested to be the primary treatment in patients with MEC and AC.
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Affiliation(s)
- Meng Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shiping Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
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14
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Lancione PJ, Kumar B, Zhao S, Mroz EA, Brock G, Rocco JW, Carrau RL, Agrawal A, Seim N, Kang SY, Ozer E, Old MO. A potential protective effect of metformin in adenoid cystic carcinoma. Oral Oncol 2020; 107:104726. [PMID: 32388409 DOI: 10.1016/j.oraloncology.2020.104726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Peter J Lancione
- The Ohio State University College of Medicine, 370 W 9(th) Ave, Columbus, OH 43210, USA.
| | - Bhavna Kumar
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Songzhu Zhao
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, 320 Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA.
| | - Edmund A Mroz
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Guy Brock
- Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, 320 Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA
| | - James W Rocco
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Ricardo L Carrau
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Amit Agrawal
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Nolan Seim
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Stephen Y Kang
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Enver Ozer
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
| | - Matthew O Old
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43212, USA.
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15
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Adenoid Cystic Carcinoma of Salivary Gland: A Ten-Year Single Institute Experience. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:56-65. [PMID: 32637166 PMCID: PMC7323724 DOI: 10.12865/chsj.46.01.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 02/02/2020] [Indexed: 12/13/2022]
Abstract
Adenoid cystic carcinoma is a rare tumor, accounting for about 7.5% of all salivary gland neoplasms. More frequent developing in minor salivary gland, this is a slow-growing tumor with a long-lasting natural evolution, quite aggressive locally, but which has a tendency toward local recurrence and even for distant metastasis. We conducted a retrospective study limited to a period of 10 years in a single medical institution to investigate the morphoclinical profile of this tumor. Thus, we have established that about 60% of the tumors developed in men, with near 40% of the cases in patients in the sixth decade and, most common, the pathology affected the parotid and minor salivary glands from the hard palate mucosa. Histopathologically, prevailed the solid variant, with 72% cases presenting perineural invasion, and 41% cases showing positive surgical resection margins. Most cases had a long-standing asymptomatic evolution, so that at the time of diagnosis, more than two thirds of the patients were at least in stage II-pTNM, and in one-fifth of the cases histopathology showed lymph nodes disseminations.
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16
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Klein Nulent TJW, van Es RJJ, Valstar MH, Smeele LE, Smit LA, Klein Gunnewiek R, Zuithoff NPA, de Keizer B, de Bree R, Willems SM. High CXCR4 expression in adenoid cystic carcinoma of the head and neck is associated with increased risk of locoregional recurrence. J Clin Pathol 2020; 73:476-482. [PMID: 31948995 DOI: 10.1136/jclinpath-2019-206273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/30/2019] [Accepted: 12/16/2019] [Indexed: 01/05/2023]
Abstract
AIM Treatment options for head and neck adenoid cystic carcinoma (AdCC) are limited in advanced disease. Chemokine receptor type 4 (CXCR4) is present in various tumour types, including AdCC. Upregulation is associated with tumour recurrence and metastasis. New CXCR4-specific diagnostic and therapeutic target agents have recently been available. This study aimed to analyse CXCR4 expression in a cohort of primary head and neck AdCC. METHODS After histopathological revision, tumour tissues of 73 consecutive patients with AdCC over 1990-2016 were sampled on a tissue microarray. Slides were immunohistochemically stained for CXCR4 and semiquantitatively scored. Associations between protein expression and cliniopathological parameters were tested. HRs were calculated using a Cox proportional hazard model. RESULTS Sixty-six tumours could be analysed. CXCR4 expression was present in 81% of the tumours with a median of 29% (IQR 1-70) positive cells. Expression was univariately correlated to perineural growth (Spearman ρ .26, p=0.04) and bone invasion (Spearman ρ .32, p=0.01), but not with tumour grade.CXCR4 expression in the primary tumour was significantly higher in tumours that recurred as compared with those that did not recur (median 60%, IQR 33-72 vs 12%, IQR 1-70, Kruskal-Wallis p=0.01). After dichotomisation, >25% of CXCR4 expressions proved an independent prognosticator for a reduced recurrence-free survival (RFS) (HR 7.2, 95% CI 1.5 to 72.4, p=0.04). CONCLUSION CXCR4 is expressed in the majority of primary AdCCs and independently correlated to worse RFS, suggesting CXCR4 as a target for imaging and therapy purposes in patients with advanced AdCC.
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Affiliation(s)
- Thomas J W Klein Nulent
- Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands .,Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert J J van Es
- Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.,Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthijs H Valstar
- Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Oral and Maxillofacial Surgery, Amsterdam UMC Cancer Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Ludwig E Smeele
- Head and Neck Oncology and Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Oral and Maxillofacial Surgery, Amsterdam UMC Cancer Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Laura A Smit
- Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | | | - Nicolaas P A Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bart de Keizer
- Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Remco de Bree
- Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stefan M Willems
- Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
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17
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Takayama K, Kato T, Nakamura T, Azami Y, Ono T, Suzuki M, Takada A, Yamaguchi H, Seto I, Nakasato T, Wada H, Kikuchi Y, Mitsudo K, Fuwa N, Murakami M. Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue. Cancers (Basel) 2019; 11:cancers11101413. [PMID: 31546728 PMCID: PMC6826952 DOI: 10.3390/cancers11101413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/12/2019] [Accepted: 09/20/2019] [Indexed: 01/06/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a very rare epithelial tumor of the salivary glands. Surgical resection is considered to be a standard therapy. However, the optimal treatment strategy for managing advanced cases has not yet been established. This study evaluated the efficacy and toxicity of proton beam therapy (PBT) combined with selective intra-arterial infusion chemotherapy (IAIC) using weekly cisplatin for locally advanced ACC of the base of the tongue. Between March 2009 and February 2018, 15 patients were treated. The median follow-up duration was 56 (range: 15–116) months. The 5-year local control and overall survival rates were 89% and 76%, respectively. With regard to late toxicities, grade 2 osteoradionecrosis was found in one patient and grade 5 pharyngeal necrosis was observed in one patient. Considering most cases were significantly advanced and inoperable, this therapy was effective in controlling the primary tumor, preserving function and maintaining the quality of life. Although improvements are needed to reduce adverse events, PBT in combination with IAIC can be a treatment option for locally advanced ACC of the base of the tongue.
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Affiliation(s)
- Kanako Takayama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Takahiro Kato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Yusuke Azami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Takashi Ono
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Akinori Takada
- Department of Radiation Oncology, Mie University Hospital, 2-174, Edobashi Tsu, Mie 514-8507, Japan.
| | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Ichiro Seto
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Tatsuhiko Nakasato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Hitoshi Wada
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise red cross hospital, 1-471-2, Funae, Ise, Mie 516-8512, Japan.
| | - Masao Murakami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
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18
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Low Molecular Weight Cytokeratin Immunostaining for Extrafollicular Reticulum Cells is an Effective Means of Separating Salivary Gland Tumor-Associated Lymphoid Proliferation from True Lymph Node Involvement. Head Neck Pathol 2019; 14:593-597. [PMID: 31541432 PMCID: PMC7413935 DOI: 10.1007/s12105-019-01080-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/14/2019] [Indexed: 10/26/2022]
Abstract
Tumor-associated lymphoid proliferation (TALP) is a well-recognized lymphocytic reaction that is commonly associated with certain salivary gland tumors. A salivary carcinoma with TALP may be confused for true lymph node involvement by that tumor, constituting a potential pitfall in tumor staging that may result in unnecessary therapeutic intervention or erroneous prognostication for patients. True lymph nodes harbor populations of extrafollicular reticulum cells (ERCs), which can be highlighted by low molecular weight cytokeratin immunohistochemistry. We sought to determine whether low molecular weight cytokeratin Cam5.2 immunostaining may be utilized to differentiate true lymph node involvement by salivary gland tumors from TALP. The surgical pathology archives of the University of Texas Southwestern Medical Center was searched for cases of salivary gland neoplasms exhibiting either TALP or true lymph node involvement. Hematoxylin and eosin-stained sections were examined. Cases were classified on the basis of a definitive lymph node capsule and subcapsular sinus, as seen on routine histologic evaluation. Low molecular weight cytokeratin Cam5.2 immunostaining was performed and evaluated on all cases. Twenty-three salivary gland carcinomas with TALP and 16 carcinomas involving a lymph node (14 carcinomas metastatic to regional lymph nodes and 2 carcinomas arising from benign lymph node inclusions) were identified. Numerous Cam5.2-positive ERCs were identified within the nodal tissue of all true lymph nodes involved by carcinoma (16 of 16 cases), while Cam5.2-positive ERCs were completely absent in all cases of salivary gland lesions with TALP (0 of 23 cases) (100% vs. 0%, p < .0001, Fisher's Exact). Utilization of low molecular weight cytokeratin Cam 5.2 immunostaining for ERCs is a highly useful tool for distinguishing true lymph node involvement by salivary gland carcinomas from TALP. This strategy may be useful in identifying genuine nodal metastasis in histologically ambiguous cases, and to avoid erroneously upstaging tumor with TALP as nodal metastasis with the resulting prognostic and therapeutic implications. Moreover, low molecular weight cytokeratin immunostaining may be useful in confirming the rare examples of salivary gland tumors arising from intranodal salivary gland inclusions.
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19
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Adenoid Cystic Carcinoma of the Bartholin's Gland: A Diagnostic Dilemma. Case Rep Obstet Gynecol 2019; 2019:1784949. [PMID: 31531253 PMCID: PMC6720055 DOI: 10.1155/2019/1784949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/22/2019] [Indexed: 11/17/2022] Open
Abstract
Adenoid cystic carcinomas of the Bartholin's gland are extremely rare and are often misdiagnosed. There are currently no definite treatment guidelines. This article describes the case of a 33-year-old female who was managed at our centre for adenoid cystic carcinoma of the Bartholin's gland. She presented with a prolonged history of a vulvar lesion which was eventually diagnosed as adenoid cystic carcinoma of the Bartholin's gland. She was subsequently treated with wide local excision of the primary and inguinal lymph node dissection followed by adjuvant radiotherapy and chemotherapy. She had gross perineural invasion on MRI imaging. The present case highlights the diagnostic dilemma in this extremely rare cancer and the literature further explores the natural history and treatment options.
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20
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NR2F1 contributes to cancer cell dormancy, invasion and metastasis of salivary adenoid cystic carcinoma by activating CXCL12/CXCR4 pathway. BMC Cancer 2019; 19:743. [PMID: 31357956 PMCID: PMC6664703 DOI: 10.1186/s12885-019-5925-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 07/11/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Salivary adenoid cystic carcinoma (SACC) can recur after removal of the primary tumor and treatment, where they can keep no clinical symptoms and dormant state for 10-15 years. NR2F1 has been demonstrated to regulate the tumor cell dormancy in various malignant tumors and has a potential impact on recurrence and metastasis of carcinoma. However, the role and significance of NR2F1 in SACC dormancy still remain unknown. METHODS A total number of 59 patients with a diagnosis of SACC were included to detected expression of NR2F1, Ki-67 by immunohistochemical (IHC) staining and terminal deoxynucleotidyl transferase-mediated dUTP nick and labeling (TUNEL). Fisher's exact test was used to examine the NR2F1 expression and clinicopathologic parameters of SACC. In vitro, SACC cell lines were transfected NR2F1 and knockdown NR2F1 respectively. CCK-8, flow cytometry, wound healing assay and transwell invasion determined SACC cell proliferation, apoptosis, cell cycle, migration and invasion respectively. Chromatin immunoprecipitation (ChIP) assays were utilized to demonstrate the potential role of NR2F1 in SACC invasion via CXCL12/CXCR4 axis. In vivo, xenografts of nude mice via subcutaneous injection or tail vein injection were used to testify the results in vitro. RESULTS Among the 59 patients with SACC, 23.73% (14/59) were positive to NR2F1 expression, a lower rate of expression compared with 60% (6/10) in normal salivary gland samples. NR2F1 was correlated with metastasis, relapse and dormancy of SACC. SACC cells with transfected NR2F1 remained dormant, as well as enhanced invasion and metastasis. Knockdown of NR2F1 via siRNA after NR2F1 overexpression restored the proliferation and the cell number in G2/M phases, and reduced the abilities of migration and invasion. In addition, NR2F1 promoted the expression of CXCL12 and CXCR4, and overexpression of CXCL12 at least partly rescued the proliferation, migration, and invasion activities induced by NR2F1 silencing. CONCLUSIONS NR2F1 may be an underlying mechanism of SACC recurrence and metastasis via regulating tumor cell dormancy through CXCL12/CXCR4 pathway.
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21
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Benchetrit L, Morse E, Judson BL, Mehra S. Positive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation. Otolaryngol Head Neck Surg 2019; 161:620-628. [PMID: 31159649 DOI: 10.1177/0194599819852094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Identify positive margin rate in a national cohort of patients with submandibular carcinoma, identify predictors of positive margins, and associate margins with overall survival. STUDY DESIGN Retrospective cohort. SETTING Commission on Cancer-accredited hospitals. SUBJECTS AND METHODS We included patients in the National Cancer Database from 2004 to 2014 who were diagnosed with submandibular carcinoma and underwent primary surgical resection. We determined the rate of positive surgical margins and associated patient, tumor, and treatment factors with positive margins via univariable and multivariable logistic regression analysis. We associated margin status with overall survival by Kaplan-Meier curve and Cox proportional hazards regression. RESULTS We identified 1150 patients with submandibular malignancy undergoing surgical resection. Positive margin rate was 41.0%. Increased odds of positive margins were seen in patients with advanced T stage (vs T1, T3: odds ratio [OR] = 3.04, P < .001; T4a: OR = 2.89, P < .001), adenoid cystic carcinoma histology (OR = 1.54, P = .020), and those treated at nonacademic facilities (OR = 1.41, P = .008). Patients who underwent a preoperative diagnostic biopsy had decreased odds of positive margins (OR = 0.72, P = .014). Positive margins were associated with reduced overall survival (58% vs 69% 5-year overall survival, P < .001; hazard ratio = 1.49, P = .001) when controlling for patient, tumor, and management factors. CONCLUSIONS The national positive margin rate of submandibular carcinoma is 41.0%. Preoperative biopsy and treatment at academic institutions independently decreased the risk of positive margins, and positive margins were independently associated with diminished overall survival. Positive margin rate for submandibular carcinoma may be considered a benchmark for quality of care.
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Affiliation(s)
- Liliya Benchetrit
- Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Elliot Morse
- Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Benjamin L Judson
- Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
| | - Saral Mehra
- Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
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22
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Tang X, Zhang C, Chen R, Zhou X, Zhang Y. Treatment of adenoid cystic carcinoma of the mobile tongue with anterolateral thigh flap reconstruction: A case report. Medicine (Baltimore) 2019; 98:e15250. [PMID: 31008961 PMCID: PMC6494219 DOI: 10.1097/md.0000000000015250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm of the salivary glands. The clinical and pathological characteristics include slow growth, perineural invasion, and local recurrence. ACC of the mobile tongue is rarely reported in the literature. PATIENT CONCERNS We describe a case of a 43-year-old man patient with numbness and growth in the tongue for 1 month duration. The patient reported a long-term smoking and drinking habit. DIAGNOSES A biopsy was carried out and histopathological analysis confirmed as diagnosis of adenoid cystic carcinoma. Computed tomography (CT) of the head and neck enhanced scanning revealed an ill-defined high density mass with altered enhanced signal entities involving the anterior 2/3rd of the tongue. INTERVENTIONS The patient was treated with surgery and adjuvant radiotherapy. Incision was placed over the anteriorly till 2/3rd of tongue and then the femoral anterolateral free flap was used to repair and reconstruct the defect of tongue. OUTCOME The patient is currently under a postsurgical 29-month regular follow-up, showing good swallowing and speaking function without any recurrence and metastasis. LESSONS This case report suggests that surgery and adjuvant radiotherapy are suitable procedures for patients with resectable ACC of the mobile tongue.
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Affiliation(s)
- Xi Tang
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
| | - Chengyao Zhang
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
| | - Rui Chen
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
- Department of Pathology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, P.R. China
| | - Xiaohong Zhou
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
| | - Yulian Zhang
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
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23
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Su W, Yang HY. [Treatment plan and prognosis of salivary adenoid cystic carcinoma with lung metastasis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:214-219. [PMID: 31168990 DOI: 10.7518/hxkq.2019.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Salivary adenoid cystic carcinoma (SACC) is a common malignant tumor in the oral and maxillofacial region and accounts for approximately 3%-5% of all head and neck carcinomas. SACC always occurs in the palatal salivary gland and parotid gland. The tumor has the characteristics of strong invasion, perineural invasion, high hematogenous metastasis, and low lymph node metastasis rate. The biological characteristics of SACC determine the specificity of clinical treatment. Thus far, few clinical trials have investigated the efficacy of systemic therapy owing to the rarity of SACC with lung metastasis. Moreover, long-term results are poor, and no consensus on standard treatment has been reached yet. This systematic review aims to provide a retrospective analysis of treatment options and prognosis for SACC with lung metastasis and evidence for future clinical treatment.
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Affiliation(s)
- Wen Su
- Dept. of Stomatology, Anhui Medical University, Hefei 230032, China;Dept. of Oral and Maxillofacial Surgery, Shenzhen Hospital, Peking University, Shenzhen 518036, China
| | - Hong-Yu Yang
- Dept. of Stomatology, Anhui Medical University, Hefei 230032, China;Dept. of Oral and Maxillofacial Surgery, Shenzhen Hospital, Peking University, Shenzhen 518036, China
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24
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Schwartz TM, Rogg JM, Griffith RC, Migliori ME. Adenoid cystic carcinoma presenting with bilateral orbital extension from the soft palate. Digit J Ophthalmol 2019; 24:1-5. [PMID: 30800005 DOI: 10.5693/djo.02.2018.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Adenoid cystic carcinoma (ACC) is a rare neoplasm of secretory epithelium that most commonly occurs in the fifth and sixth decades of life. It is characterized by high recurrence rates and poor response to chemotherapy, In the orbit, ACC usually presents as a lacrimal gland mass. We describe the rare case of a 70-year-old woman who presented with pain during mastication and bilateral facial numbness in the cranial nerve V2 distribution. She was found to have adenoid cystic carcinoma involving the orbits bilaterally without lacrimal gland involvement and without a clear primary tumor. Imaging suggested that the tumor arose from the soft palate by extension along cranial nerves V2 and V3. The patient was treated with radiation therapy with some degree of radiographic improvement 27 months after diagnosis. This case emphasizes the importance of considering adenoid cystic carcinoma when evaluating orbital tumors sparing the lacrimal gland. We also suggest the possibility of an oropharyngeal source with anterograde intracranial extension in cases of putative primary orbital ACC without lacrimal gland involvement.
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Affiliation(s)
- Tayler M Schwartz
- Warren Alpert Medical School of Brown University, Providence Rhode Island
| | - Jeffrey M Rogg
- Department of Radiology, Rhode Island Hospital, Providence, Rhode Island
| | - Rogers C Griffith
- Department of Pathology, Rhode Island Hospital, Providence Rhode Island
| | - Michael E Migliori
- Department of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island
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25
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Krucoff KB, Shammas RL, Stoecker M, Tolnitch LA. Rare breast metastasis from adenoid cystic carcinoma of the submandibular gland. BMJ Case Rep 2018; 2018:bcr-2017-223345. [PMID: 30068574 DOI: 10.1136/bcr-2017-223345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Adenoid cystic carcinomas (ACCs) are rare malignant neoplasms of exocrine glands, most commonly found in salivary glands. This report describes a 67-year-old woman with metastatic ACC to the breast, only the third reported case of its kind. The salivary gland ACC was first diagnosed 5 years prior. Routine mammogram identified a Breast Imaging and Reporting Systems (BIRADS) 4 lesion. Core breast biopsy demonstrated findings consistent with metastatic ACC to the breast. The patient ultimately underwent local excision but suffered a recurrence of disease less than 2 months later despite chemotherapy. She passed away 15 months after excision due to complications associated with a small bowel obstruction and decompensated respiratory status from pulmonary metastases. While metastatic salivary ACC to the breast is rare, it is important to be able to distinguish metastatic salivary ACC to the breast from primary ACC of the breast as the treatment considerations for the two disease processes differ significantly.
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Affiliation(s)
| | | | - Maggie Stoecker
- Department of Pathology, Duke Raleigh Hospital, Raleigh, North Carolina, USA
| | - Lisa Anne Tolnitch
- Department of Surgery, Duke University Hospital, Durham, North Carolina, USA
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Lim WS, Oh JS, Roh JL, Kim JS, Kim SJ, Choi SH, Nam SY, Kim SY. Prediction of distant metastasis and survival in adenoid cystic carcinoma using quantitative 18 F-FDG PET/CT measurements. Oral Oncol 2018; 77:98-104. [DOI: 10.1016/j.oraloncology.2017.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 11/24/2017] [Accepted: 12/20/2017] [Indexed: 12/18/2022]
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Ruhlmann V, Poeppel TD, Veit J, Nagarajah J, Umutlu L, Hoffmann TK, Bockisch A, Herrmann K, Sauerwein W. Diagnostic accuracy of 18F-FDG PET/CT and MR imaging in patients with adenoid cystic carcinoma. BMC Cancer 2017; 17:887. [PMID: 29273015 PMCID: PMC5741915 DOI: 10.1186/s12885-017-3890-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 12/08/2017] [Indexed: 11/15/2022] Open
Abstract
Background The aim of this study was to evaluate the value of 18F–FDG PET/CT (PET/CT) and MRI for local and/or whole-body restaging of adenoid cystic carcinoma of the head and neck (ACC). Methods Thirty-six patients with ACC underwent conventional MRI of the head and neck and a whole-body PET/CT and were analysed with regards to detection of a local tumor recurrence, lymph node or distant metastases. A consensus interpretation of all available imaging data was used as reference standard. Sensitivity, specificity, diagnostic accuracy, positive and negative predictive values were calculated for MRI and PET/CT. Results The sensitivity of PET/CT and MRI was 96% (89%), specificity 89% (89%), PPV 96% (96%), NPV 89% (73%) and accuracy 94% (89%) for detection of local tumors. Additionally, PET/CT revealed lymph node metastases in one patient and distant metastases in 9/36 patients. In three patients secondary primaries were found. Conclusions Whole-body PET/CT in addition to MRI of the head and neck improves detection of local tumour and metastastic spread in ACC.
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Affiliation(s)
- Verena Ruhlmann
- Department of Nuclear Medicine, University Duisburg-Essen, Medical Faculty, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - Thorsten D Poeppel
- Department of Nuclear Medicine, University Duisburg-Essen, Medical Faculty, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Johannes Veit
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Ulm, Frauensteige 12, 89070, Ulm, Germany
| | - James Nagarajah
- Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6525, GA, Nijmegen, the Netherlands
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Ulm, Frauensteige 12, 89070, Ulm, Germany
| | - Andreas Bockisch
- Department of Nuclear Medicine, University Duisburg-Essen, Medical Faculty, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Duisburg-Essen, Medical Faculty, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Wolfgang Sauerwein
- Department of Radiation Oncology, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
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König L, Hauswald H, Flechtenmacher C, Heller M, Debus J, Haberkorn U, Kratochwil C, Giesel F. Uptake of Prostate-Specific Membrane Antigen (PSMA) in adenoid cystic carcinoma - Is PSMA-PET-CT a helpful tool in radiation oncology? Clin Transl Radiat Oncol 2017; 7:79-82. [PMID: 29594233 PMCID: PMC5862661 DOI: 10.1016/j.ctro.2017.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/02/2017] [Accepted: 10/07/2017] [Indexed: 10/29/2022] Open
Abstract
This case report shows the high PSMA-uptake in a patient with an adenoid cystic carcinoma of the maxillary sinus. Due to the intense ligand-uptake additional information for target volume delineation was obtained and the Treatment plan for bimodal radiotherapy with carbon ions was adapted accordingly.
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Key Words
- ACC, Adenoid cystic carcinoma
- CTCAE, Common terminology criteria of adverse events
- HIT, Heidelberg Ion Beam Therapy Center
- IHC, Immunohistochemistry
- IMRT, intensity modulated radiotherapy
- PET-CT, Positron emission tomography-computed tomography
- PSMA, Prostate-Specific Membrane Antigen
- RBE, Relative Biological Effectiveness
- RECIST, Response Evaluation Criteria In Solid Tumors
- RT, radiotherapy
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Affiliation(s)
- Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Henrik Hauswald
- Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Christa Flechtenmacher
- Institute of Pathology, Heidelberg University Hospital, INF 224, 69120 Heidelberg, Germany
| | - Martina Heller
- Section of Molecular Urooncology, Department of Urology, Heidelberg University Hospital, INF 517, 69120 Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany
| | - Clemens Kratochwil
- Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany
| | - Frederik Giesel
- Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany
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Ni Q, Sun J, Ma C, Li Y, Ju J, Sun M. The Neuropilins and Their Ligands in Hematogenous Metastasis of Salivary Adenoid Cystic Carcinoma-An Immunohistochemical Study. J Oral Maxillofac Surg 2017; 76:569-579. [PMID: 28961428 DOI: 10.1016/j.joms.2017.08.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE We investigated the expression of neuropilin-1 (NRP1), neuropilin-2 (NRP2), vascular endothelial growth factor-A (VEGF-A), semaphorin-3A (Sema-3A), and semaphorin-3F (Sema-3F) in normal salivary gland (NSG) tissue, nonmetastatic salivary adenoid cystic carcinoma (SACC), and metastatic SACC to better understand their role in intratumoral angiogenesis and hematogenous metastasis of SACC. PATIENTS AND METHODS The study included 60 SACC patients, equally divided between nonmetastatic SACC and metastatic SACC. We used 30 NSG samples as the control. The expression of cytokines was studied by immunohistochemistry and compared using the integrated optical density. The relationship between NRP1, NRP2, VEGF-A, and Sema-3A expression and microvessel density (MVD) was analyzed in the 3 groups. RESULTS In metastatic SACC, the expression levels of NRP1 and VEGF-A were significantly greater than those in nonmetastatic SACC and NSG. The expression of Sema-3A and Sema-3F was significantly lower in metastatic SACC than that in nonmetastatic SACC and NSG (P < .0001). No significant differences were found in NRP2 expression among the 3 groups (P = .43). The MVD of metastatic SACC was significantly greater than that of nonmetastatic SACC and NSG (P < .0001). However, the lymphatic vessel density of the 3 groups was not significantly different statistically. The relationship between MVD and NRP1 or VEGF-A showed a significant positive correlation (P < .0001, for both). However, a significant negative correlation was found between the MVD and Sema-3A or Sema-3F expression (P < .0001, for both). CONCLUSIONS Hematogenous metastasis of SACC is correlated with high expression of NRP1 and VEGF-A and low expression of Sema-3A and Sema-3F. The increased numbers of microvessels induced by VEGF-A signaling, combined with NRP1, could be one of the key reasons leading to the enhanced hematogenous metastasis in SACC.
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Affiliation(s)
- Qianwei Ni
- Resident, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; and Department of Oral and Maxillofacial Surgery, General Hospital of Xinjiang Military Region, Urumqi, People's Republic of China
| | - Jinlong Sun
- Resident, Department of Stomatology, Navy General Hospital, Beijing, People's Republic of China
| | - Chao Ma
- Resident, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Yun Li
- Resident, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Jun Ju
- Resident, Center of Otolaryngology of PLA, Navy General Hospital, Beijing, People's Republic of China
| | - Moyi Sun
- Professor, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China.
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Agunbiade M, Lalehparvar S, Khaladj M. Cutaneous Adenoid Cystic Carcinoma with Perineural Invasion Diagnosed in the Foot: A Case Report. J Am Podiatr Med Assoc 2017; 107:457-460. [PMID: 28530493 DOI: 10.7547/16-091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adenoid cystic carcinoma is a rare, slow-growing neoplasm. It is most commonly located in the salivary glands, affects people older than 55 years of age, and has a predilection for women. These lesions may recur locally but have shown low metastatic potential. We present the unique case of a 71-year-old female with a nonraised hyperpigmented lesion isolated to the right heel. Confusion surrounded the clinical presentation of this dermatologic lesion, and many physicians postulated several differential diagnoses. The purpose of this case report is to bring further awareness to this rare dermatologic variant of adenoid cystic carcinoma, which has been rarely reported in the literature.
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Affiliation(s)
- Modupe Agunbiade
- Podiatric Medicine and Surgery Residency Program, Trinitas Regional Medical Center, Elizabeth, NJ
| | - Sanaz Lalehparvar
- Podiatric Medicine and Surgery Residency Program, Trinitas Regional Medical Center, Elizabeth, NJ
| | - Morteza Khaladj
- Chief of Podiatry, Trinitas Regional Medical Center, Elizabeth, NJ
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Jang S, Patel PN, Kimple RJ, McCulloch TM. Clinical Outcomes and Prognostic Factors of Adenoid Cystic Carcinoma of the Head and Neck. Anticancer Res 2017; 37:3045-3052. [PMID: 28551643 DOI: 10.21873/anticanres.11659] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/12/2017] [Accepted: 05/16/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) is a salivary gland malignancy with unpredictable growth and poorly understood prognostic factors. PATIENTS AND METHODS A database search of patients treated at a single Institution was used to identify patients with histologically-confirmed ACC. Patient, tumor, and treatment characteristics were examined via review of medical records. RESULTS Overall survival of 70 patients identified at 5, 10, and 15 years was 80.4%, 61.3%, and 29.4%, respectively. Disease recurrence was seen in 31.9%; of these, 72.7% developed distant metastasis. Older age, higher stage, skull base involvement, positive margins, and metastatic disease, but not local recurrence, predicted a worse overall survival. Higher stage and skull base disease were also associated with shorter disease-free survival. While lung metastasis was the most common, vertebral metastasis was associated with poorer survival. CONCLUSION Disease stage, positive margins, skull base involvement, perineural invasion, time to recurrence, and location of metastasis, but not nodal involvement, could serve as poor prognostic factors in ACC.
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Affiliation(s)
- Samuel Jang
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A. .,Howard Hughes Medical Institute, University of Alabama at Birmingham, Birmingham, AL, U.S.A
| | - Priyesh N Patel
- Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A
| | - Randall J Kimple
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A
| | - Timothy M McCulloch
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A
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Mannelli G, Cecconi L, Fasolati M, Santoro R, Franchi A, Gallo O. Parotid adenoid cystic carcinoma: Retrospective single institute analysis. Am J Otolaryngol 2017; 38:394-400. [PMID: 28478090 DOI: 10.1016/j.amjoto.2017.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 03/07/2017] [Accepted: 03/31/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE Adenoid cystic carcinoma (ACC) is a uncommon salivary malignant tumor. Our aim was to review our experience with parotid ACC, to identify clinical-pathological parameters predictive for outcome. MATERIALS AND METHODS We retrospectively reviewed 228 patients affected by parotid gland carcinomas surgically treated at our Institution. Forty-four ACC were included in this study. Multivariate analysis risk models were built to predict recurrence free probability (RFP), distant recurrence free probability (DRFP), overall survival (OS) and disease free survival (DFS). RESULTS Twenty-one patients (47.7%) died from ACC and 2.3% for other causes. The 41% presented local-regional recurrence, with a regional-RFP rate of 93%, and the 34% reported distant metastases (DM). The five and ten-year OS rates were 74% and 50%, respectively. CONCLUSIONS Recurrences were mainly influenced by the presence of perineural invasion and nerve paralysis, whilst female gender and age<50 were predictors for good prognosis.
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Affiliation(s)
- Giuditta Mannelli
- Otorhinolaryngology-Head and Neck Surgery Unit, Department of Surgery and Translational Medicine, University of Florence, AOU-Careggi, Via Largo Palagi 1, 50134 Florence, Italy.
| | - Lorenzo Cecconi
- Department of Statistic, Computer Science, Application, University of Florence, Italy.
| | - Martina Fasolati
- Otorhinolaryngology-Head and Neck Surgery Unit, Department of Surgery and Translational Medicine, University of Florence, AOU-Careggi, Via Largo Palagi 1, 50134 Florence, Italy
| | - Roberto Santoro
- Otorhinolaryngology-Head and Neck Surgery Unit, Department of Surgery and Translational Medicine, University of Florence, AOU-Careggi, Via Largo Palagi 1, 50134 Florence, Italy
| | - Alessandro Franchi
- Section of Anatomic Pathology, Department of Surgery and Translational Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Oreste Gallo
- Otorhinolaryngology-Head and Neck Surgery Unit, Department of Surgery and Translational Medicine, University of Florence, AOU-Careggi, Via Largo Palagi 1, 50134 Florence, Italy
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33
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Prognostic Factors in Malignant Sublingual Salivary Gland Tumors. J Oral Maxillofac Surg 2017; 75:1542-1548. [DOI: 10.1016/j.joms.2016.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/03/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022]
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Kirke DN, Chitguppi C, Rubin SJ, Truong MT, Jalisi S. Adenoid cystic carcinoma of the base of tongue: A population-based study. Am J Otolaryngol 2017; 38:279-284. [PMID: 28173954 DOI: 10.1016/j.amjoto.2017.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The objective was to assess demographic and survival patterns in patients with adenoid cystic carcinoma of the base of tongue. METHODS Patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1973 through 2012 and were categorized by age, gender, race, historical stage A, and treatment. Incidence and survival were compared with Kaplan Meier curves and mortality hazard ratios. RESULTS A total of 216 patients were included. After adjusting for age, gender, race and tumor-directed treatment, patients over the age of 70years had a significantly increased mortality [HR=2.847, 95% CI (1.499, 5.404) p=0.0014]. Furthermore mortality among patients with distant disease was significantly increased [HR=2.474 95% CI (1.459, 4.195) p=0.00008]. CONCLUSION By examining the largest collection of patients we have demonstrated that there is a significant difference in mortality based on both the age at diagnosis and in the setting of distant disease.
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Rayess HM, Dezube A, Bawab I, Raza SN, Yoo GH, Lin HS, Jacobs JR. Tumor Differentiation as a Prognostic Factor for Major Salivary Gland Malignancies. Otolaryngol Head Neck Surg 2017; 157:454-461. [PMID: 28397573 DOI: 10.1177/0194599817700593] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective The effect of tumor differentiation on prognosis of major salivary gland malignancies is controversial. The aim of this study was to determine the effect of tumor differentiation on prognosis by stage in patients with major salivary gland malignancies and to analyze which patient factors are associated with tumor differentiation. Study Design and Setting Cross-sectional analysis of Surveillance, Epidemiology, and End Results (SEER) database. Subjects and Methods In total, 9810 patients who had a major salivary gland malignancy from 2004 to 2012 were identified using the SEER database. Patients with no staging information or no information on histologic differentiation were excluded. A total of 5366 patients were included in the study. For analysis, patients were categorized by American Joint Committee on Cancer (AJCC) stage and subdivided by tumor differentiation. Multivariate analysis was used to analyze the impact of tumor differentiation on survival, tumor location (parotid, submandibular, sublingual), and sex within each AJCC stage of disease. Results Data analysis demonstrated a significant difference in histologic differentiation by stage, with P < .0001. Within stages II, III, and IV, tumor differentiation was significantly associated with a decrease in survival. There was no significant difference in tumor differentiation between the parotid and submandibular gland. Conclusion For patients with stage II, III, and IV disease, tumor differentiation was an independent predictor of survival. This information can be useful when discussing prognosis and can potentially influence management of disease.
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Affiliation(s)
- Hani M Rayess
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Aaron Dezube
- 2 Department of Anesthesiology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Ibrahim Bawab
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - S Naweed Raza
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,3 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - George H Yoo
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,3 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Ho-Sheng Lin
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,3 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA.,4 Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - John R Jacobs
- 1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,3 Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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36
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Han N, Ong H, Liu Z, Ruan M, Yang W, Zhang C. Lymph node involvement predicts poor prognosis in primary tongue adenoid cystic carcinoma: A preliminary study of 54 cases. J Craniomaxillofac Surg 2017; 45:589-594. [DOI: 10.1016/j.jcms.2017.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/13/2016] [Accepted: 01/17/2017] [Indexed: 01/20/2023] Open
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Megwalu UC, Sirjani D. Risk of Nodal Metastasis in Major Salivary Gland Adenoid Cystic Carcinoma. Otolaryngol Head Neck Surg 2017; 156:660-664. [DOI: 10.1177/0194599817690138] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective To determine the risk of nodal metastasis, examine risk factors for nodal metastasis, and evaluate the impact of nodal metastasis on survival in patients with major salivary gland adenoid cystic carcinoma. Study Design Retrospective cohort study from a large population- based cancer database. Methods Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 720 patients diagnosed with major salivary gland adenoid cystic carcinoma between 1988 and 2013. Results The overall rate of lymph node metastasis was 17%. T3 disease (odds ratio, 4.74) and T4 disease (odds ratio, 9.24) were associated with increased risk of nodal metastasis. Age, sex, and site were not associated with nodal metastasis. Nodal metastasis was associated with worse overall survival (hazard ratio, 2.56) and disease-specific survival (hazard ratio, 3.27), after adjusting for T stage, presence of distant metastasis, site, surgical resection, radiotherapy, neck dissection, age, sex, race, marital status, and year of diagnosis. Conclusion Major salivary gland adenoid cystic carcinoma carries significant risk of nodal metastasis. Advanced T stage is associated with increased risk of nodal metastasis. Nodal metastasis is associated with worse survival.
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Affiliation(s)
- Uchechukwu C. Megwalu
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Davud Sirjani
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
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Sanchez-Sanchez M, Infante-Cossio P, Lozano-Rosado R, Gonzalez-Perez LM, Japon-Rodriguez MA, Gonzalez-Padilla JD, Martinez-Sahuquillo-Marquez A, Belmonte-Caro R. Resection of upper lip adenoid cystic carcinoma and reconstruction with reverse Yu flap: Report of three cases and a literature review. Mol Clin Oncol 2017; 6:444-450. [PMID: 28451431 DOI: 10.3892/mco.2017.1150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/24/2017] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to describe the techniques that were used, and the results obtained, with the reverse Yu flap to reconstruct medium-sized upper lip defects following resection for adenoid cystic carcinoma (ACC). Data concerning the clinical and pathological characteristics of tumours, the size and location of the defects, surgical resection and the reconstructive procedure used were evaluated in three patients, as well as postoperative complications and outcomes. In all cases, a complete surgical removal of ACC was achieved with clear margins of at least 1 cm. Histopathological features revealed two cases with a predominant solid growth pattern, and one case of cribriform. Following tumour excision, the average size of the upper lip defect was 35.7×30 mm. The reverse Yu flap was raised simultaneously with tumour resection in all cases. No flap failed, and both excellent aesthetic and functional results were obtained. All the patients had a satisfactory oral competence, without microstomia, after a median of 20 months follow-up (range, 12-30 months). Adjuvant radiation therapy was not necessary in any case. On the basis of the present case study and literature review, reverse Yu flap is revealed to be a simple and reliable technique for the reconstruction of defects ranging from one-third to two-thirds of the total upper lip length, involving the commissure, nasolabial fold and philtrum, with minimal donor morbidity and a good functional and aesthetic outcome. This flap appears to be a valid surgical option for reconstruction of medium-sized upper lip defects, which may be considered following radical excision of ACC.
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Affiliation(s)
- Marta Sanchez-Sanchez
- Department of Oral and Maxillofacial Surgery, Virgen Del Rocio University Hospital, 41013 Seville, Spain
| | - Pedro Infante-Cossio
- Department of Oral and Maxillofacial Surgery, Virgen Del Rocio University Hospital, 41013 Seville, Spain
| | - Rodrigo Lozano-Rosado
- Department of Oral and Maxillofacial Surgery, Virgen Del Rocio University Hospital, 41013 Seville, Spain
| | - Luis-Miguel Gonzalez-Perez
- Department of Oral and Maxillofacial Surgery, Virgen Del Rocio University Hospital, 41013 Seville, Spain
| | | | | | | | - Rodolfo Belmonte-Caro
- Department of Oral and Maxillofacial Surgery, Virgen Del Rocio University Hospital, 41013 Seville, Spain
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Park G, Roh JL, Cho KJ, Jin M, Choi SH, Nam S, Kim S. Incidence and risk factors of late recurrence in patients with salivary gland cancer. Clin Otolaryngol 2017; 42:416-424. [DOI: 10.1111/coa.12808] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- G.C. Park
- Department of Otolaryngology; Samsung Changwon Hospital; Sungkyunkwan University School of Medicine; Changwon Korea
| | - J.-L. Roh
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - K.-J. Cho
- Department of Pathology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - M.H. Jin
- Department of Biostatistics; Samsung Changwon Hospital; Sungkyunkwan University School of Medicine; Changwon Korea
| | - S.-H. Choi
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - S.Y. Nam
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - S.Y. Kim
- Department of Otolaryngology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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40
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Yarbrough WG, Panaccione A, Chang MT, Ivanov SV. Clinical and molecular insights into adenoid cystic carcinoma: Neural crest-like stemness as a target. Laryngoscope Investig Otolaryngol 2016; 1:60-77. [PMID: 28894804 PMCID: PMC5510248 DOI: 10.1002/lio2.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 05/10/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This review surveys trialed therapies and molecular defects in adenoid cystic carcinoma (ACC), with an emphasis on neural crest-like stemness characteristics of newly discovered cancer stem cells (CSCs) and therapies that may target these CSCs. DATA SOURCES Articles available on Pubmed or OVID MEDLINE databases and unpublished data. REVIEW METHODS Systematic review of articles pertaining to ACC and neural crest-like stem cells. RESULTS Adenoid cystic carcinoma of the salivary gland is a slowly growing but relentless cancer that is prone to nerve invasion and metastases. A lack of understanding of molecular etiology and absence of targetable drivers has limited therapy for patients with ACC to surgery and radiation. Currently, no curative treatments are available for patients with metastatic disease, which highlights the need for effective new therapies. Research in this area has been inhibited by the lack of validated cell lines and a paucity of clinically useful markers. The ACC research environment has recently improved, thanks to the introduction of novel tools, technologies, approaches, and models. Improved understanding of ACC suggests that neural crest-like stemness is a major target in this rare tumor. New cell culture techniques and patient-derived xenografts provide tools for preclinical testing. CONCLUSION Preclinical research has not identified effective targets in ACC, as confirmed by the large number of failed clinical trials. New molecular data suggest that drivers of neural crest-like stemness may be required for maintenance of ACC; as such, CSCs are a target for therapy of ACC.
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Affiliation(s)
- Wendell G. Yarbrough
- Section of Otolaryngology, Department of Surgery, Yale School of MedicineNew HavenConnecticutUSA
- Yale Cancer CenterNew HavenConnecticutUSA
| | - Alexander Panaccione
- Department of Cancer BiologyVanderbilt University School of MedicineNashvilleTennesseeU.S.A.
| | - Michael T. Chang
- Section of Otolaryngology, Department of Surgery, Yale School of MedicineNew HavenConnecticutUSA
| | - Sergey V. Ivanov
- Section of Otolaryngology, Department of Surgery, Yale School of MedicineNew HavenConnecticutUSA
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Wee HE, Azhar R, Tang PY, Teo TH, Iyer NG, Tan HK, Tan NC. Diagnostic pitfall: Adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy, case report and literature review. Int J Surg Case Rep 2016; 25:102-5. [PMID: 27343735 PMCID: PMC4925904 DOI: 10.1016/j.ijscr.2016.05.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/16/2022] Open
Abstract
Adenoid Cystic Carcinoma is a malignant neoplasm originating in both major and minor salivary glands. It is characterized by slow progression, local invasiveness and perineural invasion. It may present as a hypoglossal nerve palsy. When the diagnosis is in doubt, we suggest examination under anasthesia and deep biopsy.
Introduction We describe a patient with an unusual presentation of an isolated hypoglossal nerve palsy as a result of perineural invasion (PI) from adenoid cystic carcinoma (ACC). We will also discuss the diagnostic pitfalls as well as present a short literature review of adenoid cystic carcinomas and suggest improvement to the current diagnostic algorithm for isolated hypoglossal nerve palsies. Presentation of case A 63 year old Malay female presented with progressive dysphagia and slurred speech for one year. Physical examination showed unilateral right tongue wasting, fasciculation and deviation to the right. An MRI showed atrophy of the tongue due to denervation and subsequently she was treated in a neurology clinic for 8 months. Due to lack of improvement, she was referred to our surgical unit and underwent examination under anaesthesia (EUA) and biopsy. Histology showed adenoid cystic carcinoma with perineural involvement, resulting in lower motor neuron signs. She underwent radiotherapy to the base of her tongue (70 Gy/35#). A PET-CT one month post treatment showed complete response. Discussion Adenoid cystic carcinoma (ACC) is a salivary gland neoplasm. It is characterized by local invasiveness with frequent recurrence and indolent growth. It affects major salivary glands more than minor salivary glands. In malignancies that have a propensity for PI such as ACC, patients may present atypically with nerve palsies. In infiltrative lesions, the primary tumour may not be evident on magnetic resonance imaging. Therefore, to achieve a diagnosis, a high index of suspicion is required. When the diagnosis is in question, deep biopsy and positron emission tomography may be useful.
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Affiliation(s)
- Hide Elfrida Wee
- Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
| | - Rafay Azhar
- Singapore General Hospital, Outram Rd, Singapore 169608.
| | - Po Yin Tang
- Singapore General Hospital, Outram Rd, Singapore 169608.
| | - Tze Hern Teo
- Division of Oncologic Imaging, National Cancer Center Singapore, 11 Hospital Drive, Singapore 169610.
| | | | - Hiang Khoon Tan
- Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
| | - Ngian Chye Tan
- Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
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42
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Nam SJ, Roh JL, Cho KJ, Choi SH, Nam SY, Kim SY. Risk Factors and Survival Associated with Distant Metastasis in Patients with Carcinoma of the Salivary Gland. Ann Surg Oncol 2016; 23:4376-4383. [PMID: 27338749 DOI: 10.1245/s10434-016-5356-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Salivary gland cancer (SGC) is rare and has various pathologies and metastatic potentials. Because distant metastasis can be observed after treatment, as well as at initial presentation, this study aimed to investigate the rates, risk factors, and survivals associated with distant metastasis in patients with SGC. METHODS This study involved 454 consecutive patients with previously untreated SGC who were treated at our tertiary referral center. Clinical factors, operative and pathologic findings, and treatment outcomes were carefully reviewed. Univariate and multivariate analyses were performed to identify factors associated with distant metastasis and their associations with distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS). RESULTS Of 454 patients, 95 (20.9 %) presented with distant metastases; of these, 7 (7.4 %) were at the initial stage, while 88 (92.6 %) were detected during a median follow-up of 100 months (range 24-282). Distant metastases to single and multiple organs were found in 64 (67.4 %) and 31 (32.6 %) patients, respectively, with the most common site being the lung (77.9 %). In multivariate analysis, a non-parotid tumor site, high histological grade, perineural invasion, and T3-4 and N2-3 classifications were independent variables of DMFS, while distant metastasis was an independent variable of CSS and OS (p < 0.005 each). The median survival duration after distant metastasis development was 15 months (range 2-103). CONCLUSIONS Distant metastasis frequently develops after treatment for SGC and is associated with poor survival outcomes; thus, close surveillance may be required for patients with SGC and risk factors.
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Affiliation(s)
- Soo Jung Nam
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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43
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Yaga US, Gollamudi N, Mengji AK, Besta R, Panta P, Prakash B, Rajashekar E. Adenoid cystic carcinoma of the palate: case report and review of literature. Pan Afr Med J 2016; 24:106. [PMID: 27642445 PMCID: PMC5012755 DOI: 10.11604/pamj.2016.24.106.8596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/13/2016] [Indexed: 11/24/2022] Open
Abstract
Adenoid Cystic Carcinoma (ACC) is a rare tumor constitutes for less than 1% of head and neck malignancies and 10% of all salivary gland tumors. Palate is the most common site to be involved in the oral cavity followed by parotid gland and submandibular gland. They are usually asymptomatic, slow growing, characteristically shows infiltrative growth and perineural invasion. This paper reports a case of Adenoid Cystic Carcinoma in a 35 year old female man reported with a swelling on the left side of palate involving the hard and soft palate since 8 months which was diagnosed histopathologically and review of literature of the peculiar clinical, and histopathological features.
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Affiliation(s)
- Uday Shankar Yaga
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Nishanth Gollamudi
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Ashwini Kumar Mengji
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Radhika Besta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Prashanth Panta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Bhanu Prakash
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Edunuri Rajashekar
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
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44
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Tabrizi R, Aliabadi E, Maleki MJ, Barouj MD. Association between clinical features, treatment, and recurrence rate of adenoid cystic carcinoma of the palate: a 10-year retrospective study. Br J Oral Maxillofac Surg 2016; 54:648-51. [PMID: 27094499 DOI: 10.1016/j.bjoms.2016.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/23/2016] [Indexed: 10/21/2022]
Abstract
Adenoid cystic carcinoma (ACC) is both invasive and clinically unpredictable, and our aim was to evaluate the factors that affect its recurrence in the palate. We retrospectively studied 38 patients who had ACC of the palate treated surgically, and the outcome measure was recurrence during the mean (SD) followup time of 55 (18) months. Age, sex, T-stage, bony involvement, duration of follow up, histological type, perineural invasion, and surgical margins were all recorded. Results showed no association between recurrence, and age or histopathological types. However, T-stage (p=0.001), sex (p=0.04), and bony and perineural involvement (p=0.01 in each case) were significantly associated with recurrent tumour. Close superior and posterior margins (< 2mm) were also associated with recurrence (p=0.001 in each case). Large tumours with bony and perineural involvement, together with close superior and posterior surgical margins, had a higher risk of recurrence.
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Affiliation(s)
- Reza Tabrizi
- Assistant Professor of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ehsan Aliabadi
- Assistant Professor of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Maleki
- Student Research Committee, School of Dentistry, International Branch, Shiraz University of Medical Sciences, Shiraz, Iran
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45
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Amit M, Eran A, Billan S, Fridman E, Na'ara S, Charas T, Gil Z. Perineural Spread in Noncutaneous Head and Neck Cancer: New Insights into an Old Problem. J Neurol Surg B Skull Base 2016; 77:86-95. [PMID: 27123384 PMCID: PMC4846400 DOI: 10.1055/s-0036-1571834] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Head and neck malignancies have the propensity to invade nerves. Perineural tumor invasion is common, with some series reporting rates of 30 to 100%. Squamous cell carcinoma and adenoid cystic carcinoma are the most commonly involved tumors. The most commonly involved nerves are the trigeminal (cranial nerve [CN] V) and facial (CN VII) and their branches. Neural spread away from a tumor is encountered less often and usually causes specific symptoms such as pain, muscle weakness, and atrophy, depending on the involved nerves. While clinical symptoms and physical examination may suggest the presence of neural invasion, specific imaging modalities such as fat-suppressed T1-weighted magnetic resonance images, should be utilized to identify perineural tumor spread in its early phases. Perineural tumor spread should be considered and addressed in the treatment planning of patients with head and neck or skull base cancers as it can influence the extent of surgery, and the dosage and fields of radiation therapy. In the current review, we discuss the clinical course of perineural tumor spread and its therapeutic implications.
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Affiliation(s)
- Moran Amit
- The Laboratory for Applied Cancer Research, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
- The Head and Neck Center, Department of Otolaryngology-Head and Neck Surgery, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Ayelet Eran
- Department of Radiology, Rambam Healthcare Campus, Israel Institute of Technology, Haifa, Israel
| | - Salem Billan
- Department of Oncology, Rambam Healthcare Campus, Israel Institute of Technology, Haifa, Israel
| | - Eran Fridman
- The Laboratory for Applied Cancer Research, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
- The Head and Neck Center, Department of Otolaryngology-Head and Neck Surgery, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Shorook Na'ara
- The Laboratory for Applied Cancer Research, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
- The Head and Neck Center, Department of Otolaryngology-Head and Neck Surgery, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Tomer Charas
- Department of Oncology, Rambam Healthcare Campus, Israel Institute of Technology, Haifa, Israel
| | - Ziv Gil
- The Laboratory for Applied Cancer Research, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
- The Head and Neck Center, Department of Otolaryngology-Head and Neck Surgery, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, The Technion, Israel Institute of Technology, Haifa, Israel
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Meyers M, Granger B, Herman P, Janot F, Garrel R, Fakhry N, Poissonnet G, Baujat B. Head and neck adenoid cystic carcinoma: A prospective multicenter REFCOR study of 95 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 133:13-7. [PMID: 26493113 DOI: 10.1016/j.anorl.2015.09.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the clinical, histological and therapeutic characteristics of a prospective multicenter series of 95 head and neck adenoid cystic carcinoma patients, and to determine any prognostic factors for disease-free survival. PATIENTS AND METHODS Ninety-five patients with adenoid cystic carcinoma were included in the Réseau d'Expertise Français Des Cancers ORL Rares (REFCOR, French Rare Head and Neck Cancer Expert Network) database between 2009 and 2012. The primary site was the salivary glands in 39 cases, sinus cavities (including hard palate) in 36 cases, pharynx-larynx-trachea in 14 cases, and lips and oral cavity in 4 cases. The tumor was stage I in 15% of cases, stage II in 23%, stage III in 26% and stage IV in 36%. Nine patients had cervical lymph node involvement and 5 had metastases at diagnosis. Fifty-six percent of patients were managed by surgery with postoperative radiation therapy. During follow-up, 3 patients died, 9 developed metastases and 12 showed recurrence or local progression. RESULTS Mean follow-up was 18 months. On univariate analysis, disease-free survival correlated with T stage (P=0.05), N stage (P=0.003), resection margins (P=0.04), lymph node involvement on histology (P=0.01), and absence of chemotherapy (P=0.03). On multivariate analysis, disease-free survival correlated with T stage (P=0.01), N stage (P=0.09) and surgery (P=0.005). CONCLUSION The essential issue in adenoid cystic carcinoma is long-term control. The present results confirm that the reference attitude is radical surgical resection for optimal local control. Adjuvant radiation therapy did not emerge as a prognostic factor. This study also provides a starting-point for translational studies in pathology and genetics.
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Affiliation(s)
- M Meyers
- Service ORL-CCF, hôpital Foch, 40, rue Worth, 92151 Suresnes, France; Service ORL-CCF, hôpital Tenon, université Paris VI, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - B Granger
- Service de santé publique et biostatistiques, hôpital Pitié Salpétrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris, France
| | - P Herman
- Service ORL-CCF, hôpital Lariboisière, université Paris VII, AP-HP, 2, rue Ambroise-Paré, 75475 Paris, France
| | - F Janot
- Département ORL-CCF, institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - R Garrel
- Service ORL-CCF, hôpital Gui-de-Chauliac, université de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - N Fakhry
- Service ORL-CCF, hôpital la Timone, université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Poissonnet
- Service ORL-CCF, centre Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - B Baujat
- Service ORL-CCF, hôpital Tenon, université Paris VI, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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47
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Park S, Nam SJ, Keam B, Kim TM, Jeon YK, Lee SH, Hah JH, Kwon TK, Kim DW, Sung MW, Heo DS, Bang YJ. VEGF and Ki-67 Overexpression in Predicting Poor Overall Survival in Adenoid Cystic Carcinoma. Cancer Res Treat 2015; 48:518-26. [PMID: 26194375 PMCID: PMC4843710 DOI: 10.4143/crt.2015.093] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/13/2015] [Indexed: 12/25/2022] Open
Abstract
Purpose The purpose of this study was to evaluate potential prognostic factors in patients with adenoid cystic carcinoma (ACC). Materials and Methods A total of 68 patients who underwent curative surgery and had available tissue were enrolled in this study. Their medical records and pathologic slides were reviewed and immunohistochemistry for basic fibroblast growth factor, fibroblast growth factor receptor (FGFR) 2, FGFR3, c-kit, Myb proto-oncogene protein, platelet-derived growth factor receptor beta, vascular endothelial growth factor (VEGF), and Ki-67 was performed. Univariate and multivariate analysis was performed for determination of disease-free survival (DFS) and overall survival (OS). Results In univariate analyses, primary site of nasal cavity and paranasal sinus (p=0.022) and Ki-67 expression of more than 7% (p=0.001) were statistically significant factors for poor DFS. Regarding OS, perineural invasion (p=0.032), high expression of VEGF (p=0.033), and high expression of Ki-67 (p=0.007) were poor prognostic factors. In multivariate analyses, primary site of nasal cavity and paranasal sinus (p=0.028) and high expression of Ki-67 (p=0.004) were independent risk factors for poor DFS, and high expression of VEGF (p=0.011) and Ki-67 (p=0.011) showed independent association with poor OS. Conclusion High expression of VEGF and Ki-67 were independent poor prognostic factors for OS in ACC.
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Affiliation(s)
- Seongyeol Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Jeong Nam
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.,The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Pathology, National Cancer Center, Goyang, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - J Hun Hah
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Tack-Kyun Kwon
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-Whun Sung
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yung-Jue Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Kobayashi K, Ando M, Saito Y, Kondo K, Omura G, Shinozaki-Ushiku A, Fukayama M, Asakage T, Yamasoba T. Nerve Growth Factor Signals as Possible Pathogenic Biomarkers for Perineural Invasion in Adenoid Cystic Carcinoma. Otolaryngol Head Neck Surg 2015; 153:218-24. [PMID: 25968060 DOI: 10.1177/0194599815584762] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 04/09/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The molecular mechanisms underlying perineural invasion (PNI)-a characteristic pathological feature of adenoid cystic carcinoma (ACC)-remain largely unclear. Recently, nerve growth factor (NGF) has been implicated in perineural invasion in certain malignancies. Overexpression of Myb related to the MYB-NFIB fusion gene in ACC has also been correlated with perineural invasion and survival. However, this concept is controversial. The aim of this study was to examine the expression of NGF together with its receptors, tropomyosin receptor kinase A (TrkA) and p75NRT, and Myb in ACC and assess their relationship with perineural invasion and survival. STUDY DESIGN Case series with chart review. SETTING The University of Tokyo Hospital. SUBJECTS AND METHODS We retrospectively analyzed 37 patients with ACC surgically treated from 1991 to 2011. We examined expression levels of NGF, TrkA, p75NRT, and Myb in the ACC specimens and their correlations with PNI and prognosis. RESULTS NGF, TrkA, p75NRT, and Myb overexpression rates were 65%, 65%, 30%, and 62%, respectively. Pearson product-moment correlation coefficient revealed a strong correlation between NGF/TrkA immunostaining and PNI (NGF: r = 0.68, P < .0001; TrkA: r = 0.53, P = .0007). Moreover, NGF overexpression was significantly associated with worse 8-year local control rate (27% vs 80%, P = .005). However, p75NRT and Myb expression was related to neither perineural invasion nor survival. CONCLUSION Our findings demonstrated that NGF and TrkA overexpression, but not Myb and p75NRT overexpression, may contribute to PNI and thus cause local recurrence in patients with ACC.
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Affiliation(s)
- Kenya Kobayashi
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan Department of Head and Neck Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mizuo Ando
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuki Saito
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Kenji Kondo
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Go Omura
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Masashi Fukayama
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Takahiro Asakage
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital, Tokyo, Japan
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49
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Rettig EM, Tan M, Ling S, Yonescu R, Bishop JA, Fakhry C, Ha PK. MYB rearrangement and clinicopathologic characteristics in head and neck adenoid cystic carcinoma. Laryngoscope 2015; 125:E292-9. [PMID: 25963073 DOI: 10.1002/lary.25356] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/31/2015] [Accepted: 04/03/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Salivary gland adenoid cystic carcinoma (ACC) is rare, aggressive, and challenging to treat. Many ACCs have a t(6;9) chromosomal translocation resulting in a MYB-NFIB fusion gene, but the clinical significance is unclear. The purposes of this study were to describe the clinicopathologic factors impacting survival and to determine the prevalence and clinical significance of MYB-NFIB fusion. STUDY DESIGN Case series. METHODS Medical records of patients treated for ACC of the head and neck from 1974 to 2011 were reviewed and clinicopathologic data recorded. Fluorescence in situ hybridization (FISH) was used to detect MYB rearrangement in archival tumor tissue as a marker of MYB-NFIB fusion. RESULTS One hundred fifty-eight patients were included, with median follow-up 75.1 months. Median overall survival was 171.5 months (95% confidence interval [CI] = 131.9-191.6), and median disease-free survival was 112.0 months (95% CI = 88.7-180.4). Advanced stage was associated with decreased overall survival (adjusted ptrend < 0.001), and positive margins were associated with decreased disease-free survival (adjusted hazard ratio [aHR] = 8.80, 95% CI = 1.25-62.12, P = 0.029). Ninety-one tumors were evaluable using FISH, and 59 (65%) had evidence of a MYB-NFIB fusion. MYB-NFIB positive tumors were more likely than MYB-NFIB negative tumors to originate in minor salivary glands (adjusted prevalence ratios = 1.51, 95% CI = 1.07-2.12, P = 0.019). MYB-NFIB tumor status was not significantly associated with disease-free or overall survival (hazard ratio [HR] = 1.53, 95% CI = 0.77-3.02, P = 0.22 and HR = 0.91, 95% CI = 0.46-1.83, P = 0.80, respectively, for MYB-NFIB positive compared with MYB-NFIB negative tumors). CONCLUSION Stage and margin status were important prognostic factors for ACC. Tumors with evidence of MYB-NFIB fusion were more likely to originate in minor salivary glands, but MYB-NFIB tumor status was not significantly associated with prognosis. LEVEL OF EVIDENCE 4.
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Affiliation(s)
| | - Marietta Tan
- Department of Otolaryngology-Head and Neck Surgery
| | | | - Raluca Yonescu
- Department of Pathology, Johns Hopkins University School of Medicine
| | - Justin A Bishop
- Department of Pathology, Johns Hopkins University School of Medicine
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery.,Milton J. Dance Jr. Head and Neck Center, Greater Baltimore Medical Center.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A
| | - Patrick K Ha
- Department of Otolaryngology-Head and Neck Surgery.,Milton J. Dance Jr. Head and Neck Center, Greater Baltimore Medical Center
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Coca-Pelaz A, Rodrigo JP, Bradley PJ, Vander Poorten V, Triantafyllou A, Hunt JL, Strojan P, Rinaldo A, Haigentz M, Takes RP, Mondin V, Teymoortash A, Thompson LDR, Ferlito A. Adenoid cystic carcinoma of the head and neck--An update. Oral Oncol 2015; 51:652-61. [PMID: 25943783 DOI: 10.1016/j.oraloncology.2015.04.005] [Citation(s) in RCA: 301] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/01/2015] [Accepted: 04/03/2015] [Indexed: 01/20/2023]
Abstract
This article provides an update on the current understanding of adenoid cystic carcinoma of the head and neck, including a review of its epidemiology, clinical behavior, pathology, molecular biology, diagnostic workup, treatment and prognosis. Adenoid cystic carcinoma is an uncommon salivary gland tumor that may arise in a wide variety of anatomical sites in the head and neck, often with an advanced stage at diagnosis. The clinical course is characterized by very late recurrences; consequently, clinical follow-up should extend at least >15 years. The optimal treatment is generally considered to be surgery with postoperative radiotherapy to optimize local disease control. Much effort has been invested into understanding the tumor's molecular biological processes, aiming to identify patients at high risk of recurrence, in hopes that they could benefit from other, still unproven treatment modalities such as chemotherapy or biological therapy.
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Affiliation(s)
- Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Spain
| | - Patrick J Bradley
- Department of Otorhinolaryngology-Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, UK; European Salivary Gland Society, Geneva, Switzerland
| | - Vincent Vander Poorten
- European Salivary Gland Society, Geneva, Switzerland; Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | | | - Missak Haigentz
- Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vanni Mondin
- University of Udine School of Medicine, Udine, Italy
| | - Afshin Teymoortash
- Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Marburg, Germany
| | - Lester D R Thompson
- Department of Pathology, Woodland Hills Medical Center, Woodland Hills, CA, USA
| | - Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy.
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