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Qin G, Wu L, Li C, Zhang Q, An Z, Qin J. Prognostic factors for sublingual gland carcinoma: a population-based Surveillance, Epidemiology and End Results database study. J Int Med Res 2023; 51:3000605231187940. [PMID: 37944187 PMCID: PMC10637180 DOI: 10.1177/03000605231187940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/15/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE To identify the clinical features and prognostic factors for sublingual gland carcinoma. METHODS This was a case-control study. Patients with surgically treated sublingual gland carcinoma were retrospectively included in the Surveillance, Epidemiology and End Results database and divided into adenoid cystic carcinoma (ACC) and non-ACC groups. Primary outcome variables were disease-specific survival (DSS) and overall survival (OS). Prognostic factors for each group were analyzed using Cox models. RESULTS We included 251 patients (115 men and 136 women). Compared with the non-ACC group, the ACC group had a larger average tumor size and received more adjuvant radiotherapy. In patients with ACC, the pathologic grade had an independent impact on DSS and OS, and patients who were undergoing adjuvant chemotherapy had worse DSS than those who were not receiving chemotherapy. In the non-ACC group, pathologic grade IV, lymph node metastasis, and adjuvant chemotherapy were associated with poor DSS and OS, and tumor extension predicted worsening DSS. CONCLUSIONS In sublingual gland carcinoma, the pathologic grade and adjuvant chemotherapy were the most important prognostic factors, whereas lymph node metastasis had a negative impact in non-ACC patients but not in ACC patients.
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Affiliation(s)
- Gang Qin
- Department of Stomatology, Rizhao Central Hospital, Shandong Province, PR China
| | - Lei Wu
- Department of Stomatology, Rizhao Central Hospital, Shandong Province, PR China
| | - Chengxia Li
- Department of Stomatology, Rizhao Central Hospital, Shandong Province, PR China
| | - Qian Zhang
- Department of Stomatology, Rizhao Central Hospital, Shandong Province, PR China
| | - Zhongjun An
- Department of Stomatology, Rizhao Central Hospital, Shandong Province, PR China
| | - Jianhua Qin
- Department of Stomatology, Rizhao Central Hospital, Shandong Province, PR China
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Khan J, Ullah A, Goodbee M, Lee KT, Yasinzai AQK, Lewis JS, Mesa H. Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances. Cancers (Basel) 2023; 15:3373. [PMID: 37444484 DOI: 10.3390/cancers15133373] [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: 03/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Acinic cell carcinoma (AciCC) comprises 6-7% of all salivary gland neoplasms and is the second most common salivary gland malignancy in children. Like many salivary gland carcinomas, it is considered low grade but occasionally it behaves aggressively. Understanding the risk factors associated with recurrence, metastasis, and death is important to determine the counseling and management of individual patients. Older population-based studies are presumed to have been confounded by the misclassification of other neoplasms as AciCC, in particular secretory carcinoma and cystadenocarcinoma. Since diagnostic tools to reliably separate these entities have been available for over a decade, reevaluation of epidemiologic data limited to the 21st century should allow a better characterization of the clinicopathological characteristics of AciCC. METHODS Our study extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2018. Cox regression model analysis was performed to identify risk factors independently affecting survival. RESULTS Data for 2226 patients with AciCC were extracted from the database. Most patients were females: 59%, and white: 80.5%, with a mean age at diagnosis of 51.2 (SD ± 18.7) years. Most cases (81%) were localized at presentation. Tumor size was less than 2 cm in 42%, 2-4 cm in 47%, and >4 cm in 11%. Low-grade tumors had 5-year survival > 90%, whereas high-grade tumors had survival < 50%. Of the patients with known lymph node status only 7.3% had nodal metastases. Distant metastases were documented in 1.1%, involving lungs 44%, bone 40%, liver 12%, and brain 4%. The most common treatment modality was surgery alone: 63.6% followed by surgery and adjuvant radiation: 33%. A few received chemotherapy (1.8%) or multimodality therapy (1.2%). The 5-year overall survival rate was 90.6% (95%CI 89.1-91.9), and disease-specific survival was 94.6% (95%CI 93.3-95.6). Multivariable cox regression analysis showed that undifferentiated (HR = 8.3) and poorly differentiated tumor grade (HR = 6.4), and metastasis (HR = 5.3) were the worst independent prognostic factors. Other poor risk factors included age > 50 (HR = 3.5) and tumor size > 4 cm (HR = 2.5). CONCLUSIONS In the US, AciCC is more common in middle age white females, and most tumors are less than 4 cm and localized at diagnosis. The most relevant negative prognostic factor was high tumor grade which was associated with higher hazard ratios for death than all other variables, including regional or distant metastases at presentation.
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Affiliation(s)
- Jaffar Khan
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Asad Ullah
- Department of Pathology, Microbiology, Immunology Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mya Goodbee
- Medical College of Georgia, Augusta, GA 30912, USA
| | | | | | - James S Lewis
- Department of Pathology, Microbiology, Immunology Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hector Mesa
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Chatelet F, Ferrand FR, Atallah S, Thariat J, Mouawad F, Fakhry N, Malard O, Even C, de Monès E, Uro-Coste E, Benzerdjeb N, Hans S, Testelin S, Mauvais O, Evrard D, Bastit V, Salas S, Espitalier F, Classe M, Digue L, Doré M, Wong S, Dupin C, Nguyen F, Bettoni J, Lapierre A, Colin E, Philouze P, Vergez S, Baujat B, Herman P, Verillaud B. Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients. Eur J Cancer 2023; 185:11-27. [PMID: 36947928 DOI: 10.1016/j.ejca.2023.02.020] [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: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Acinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The aim of this work was to analyse data from the national REFCOR multicenter cohort (i) to investigate the prognostic factors influencing survival outcomes in AciCC, (ii) to assess the impact on survival of postoperative radiotherapy (RT) in patients treated for AciCC without high-grade transformation and (iii) to explore the prognostic impact of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary glands. PATIENTS AND METHODS Data from all the patients treated for salivary AciCC between 2009 and 2020 were extracted from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate analyses. Propensity score matching was used to assess the impact of postoperative RT and prophylactic ND on DFS. RESULTS A total of 187 patients were included. After a median follow-up of 53 months, their 5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis, male sex, older age, higher T and N status, and high grade were independently associated with a worse DFS. In the subpopulation analysed after propensity score matching, patients with cN0 AciCC without high-grade transformation who were treated by surgery and RT did not have an improved DFS compared to patients who were treated by surgery alone (hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3-T4 status and intermediate/high histological grade. After propensity score matching, prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16). CONCLUSIONS These results suggest that (i) long-term follow-up (>5 years) should be considered in patients with AciCC, (ii) treatment by surgery alone could be an option in selected cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND may be considered preferentially in patients with T3-T4 status and/or intermediate/high histological grade.
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Affiliation(s)
- Florian Chatelet
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France.
| | - François Régis Ferrand
- French Armed Forces Biomedical Research Institute, F-91220 Brétigny sur Orge, France; Head and Neck Oncology Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | - Sarah Atallah
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la chine, F-75020 Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 16 Avenue Paul Vaillant Couturier, F-94807 Villejuif, France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre Francois Baclesse, F-14000 Caen, France; ARCHADE Research Community, F-14000 Caen, France; Laboratoire de physique Corpusculaire IN2P3/ENSICAEN/CNRS UMR 6534-Normandie Université, F-14000 Caen, France
| | - François Mouawad
- Department of ENT-Head and Neck Surgery, Université de Lille, Hôpital Huriez, CHU de Lille, Rue Michel Polonovski, 59000 Lille, France; Inserm U 908, Université des Sciences et Technologies de Lille, UFR de Biologie - SN3, 59655 Villeneuve d'Ascq, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, CHU La Conception, AP-HM. Aix-Marseille Univ (AMU), Marseille, France
| | - Olivier Malard
- Service d'ORL et de chirurgie cervico-faciale CHU 1, INSERM U1229-RMeS, Place A. Ricordeau Hôtel-Dieu, F-44093 Nantes Cedex, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | | | - Emmanuelle Uro-Coste
- Department of Pathological Anatomy and Histology-Cytology, Rangueil Hospital, Toulouse, France
| | - Nazim Benzerdjeb
- Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University, Lyon 1, France
| | - Stéphane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Sylvie Testelin
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Diane Evrard
- Université de Paris, Department of ENT-Head and Neck Surgery, Hôpital Bichat, AP-HP, 46 Rue Henri Huchard, F-75018 Paris, France
| | - Vianney Bastit
- Department of ENT-Head and Neck Surgery, François Baclesse Centre, 3 rue du Général Harris, 14000, Caen, France
| | - Sébastien Salas
- Medical Oncology Department, Centre Hospitalier (CHU) La Timone, F-13000, Marseille, France
| | - Florent Espitalier
- Department of Otolaryngology-Head and Neck Surgery, CHU de Nantes, F-44093 Nantes, France
| | - Marion Classe
- Pathology Department, Gustave Roussy Cancer Campus, France
| | | | - Mélanie Doré
- Institut de cancérologie de l'Ouest Nantes, 2 boulevard Jacques Monod, F-44805 Saint Herblain, France
| | - Stéphanie Wong
- Radiation Oncology Department, Hôpital Timone Adultes, 264 Rue Saint-Pierre, F-13005 Marseille, France
| | - Charles Dupin
- Department of Radiation Therapy, Hôpital de Haut Lévèque, Bordeaux University Hospital-CHU, F-33000 Bordeaux, France
| | - France Nguyen
- Onco-radiotherapy Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | - Jeremie Bettoni
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Ariane Lapierre
- Claude Bernard University, Lyon 1, France; Department of Radiation Oncology, Centre Hospitalier Lyon Sud, 165 Chem. du Grand Revoyet, F-69310 Pierre-Bénite, France
| | - Emilien Colin
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Pierre Philouze
- Claude Bernard University, Lyon 1, France; Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse - Oncopôle, University Hospital of Toulouse, F-31100 Toulouse, France
| | - Bertrand Baujat
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la chine, F-75020 Paris, France
| | - Philippe Herman
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France; Université de Paris, INSERM U1141, Unité"NeuroDiderot", Université de Paris, F-75006 Paris, France
| | - Benjamin Verillaud
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France; Université de Paris, INSERM U1141, Unité"NeuroDiderot", Université de Paris, F-75006 Paris, France
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Meiklejohn K, Hrones M, Wang M, Prasad ML, Cai G, Adeniran A, Gilani SM. Diagnosis of acinic cell carcinoma of the salivary gland on cytology specimens: Role of NOR-1 (NR4A3) immunohistochemistry. Cytopathology 2023; 34:219-224. [PMID: 36825365 DOI: 10.1111/cyt.13222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/02/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES Acinic cell carcinoma (AcCC) is often a challenging diagnosis on cytology. Recently, NOR-1 (NR4A3) has been demonstrated as a sensitive and specific marker for AcCC. Therefore, we conducted this study to evaluate NOR-1 expression in AcCC cytology specimens and to compare its reactivity in other salivary gland tumours (non-AcCC). METHODS We retrospectively reviewed our database and selected cytology cases with available cell blocks, including 10 AcCC and 24 non-AcCC tumours (12 benign tumours and 12 malignant tumours). NOR-1 (1:50 dilution; SC393902 [H-7]; Santa Cruz Biotech) immunohistochemistry (IHC) was performed on all cases. RESULTS All AcCC cases except two (2/10, 80%) showed positive nuclear staining of variable intensity for NOR-1, with the majority of cases (75%) demonstrating at least moderately intense nuclear expression. All non-AcCC cases were negative for NOR-1, demonstrating a specificity of 100%. CONCLUSION We conclude that NOR-1 IHC is sensitive and very specific on cytology specimens and is able to distinguish AcCC from its mimickers reliably and classify them appropriately for further management.
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Affiliation(s)
- Karleen Meiklejohn
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Morgan Hrones
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Minhua Wang
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Manju L Prasad
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Guoping Cai
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Adebowale Adeniran
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Syed M Gilani
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
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Pang Y, Sun L, Liu H, Ma J. Differential diagnosis and treatment of salivary secretory carcinoma and acinic cell carcinoma. Oral Oncol 2021; 119:105370. [PMID: 34157553 DOI: 10.1016/j.oraloncology.2021.105370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 02/08/2023]
Abstract
Secretory carcinoma (SC) and acinic cell carcinoma (AciCC) are two rare tumors originating in the salivary gland of the head and neck. Before the World Health Organization (WHO) classified SC as a new entity in 2017, the majority of SC cases were incorrectly diagnosed as AciCC. Indeed, they are similar in biological behaviors, clinical manifestations and histomorphological features. Especially, SC and zymogen granule-poor AciCC are difficult to differentiate, which brings a tough challenge in clinical diagnosis. This article provides an updated understanding of the differential diagnosis in SC and AciCC from two main perspectives: histopathology and molecular genetics. The targeted therapies for both tumors are also mentioned. It aims to give some hints in clinical diagnosis and treatment, in hopes that patients with adequate diagnosis could obtain the opportunityformore effective treatment.
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Affiliation(s)
- Yu Pang
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province 610041, PR China.
| | - Lingqi Sun
- Department of Neurology, Air Force Hospital of Western Theater Command, Chengdu, Sichuan Province 610041, PR China
| | - Huijia Liu
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China
| | - Ji Ma
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China.
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