Survival Outcomes and Prognostic Factors in Head and Neck Adenoid Cystic Carcinoma Following Curative Surgery

Objective: Adenoid cystic carcinoma (ACC) is a rare malignancy characterized by indolent progression and a high-risk of local recurrence and distant metastasis.This study aimed to identify predictors of recurrence, distant metastasis, and survival among patients with head and neck ACC who underwent primary curative surgery. Material and Methods:We conducted a retrospective analysis of patients with head and neck ACC diagnosed between January 2005 and December 2023.The clinical and pathological parameters were assessed to identify prognostic factors.Results: Among the 125 patients included in the study, recurrence occurred in 73 patients (58.4%) and distant metastasis was detected in 46 patients (36.8%).The estimated 5-year, 10-year, and 15-year recurrence-free survival (RFS) rates were 49%, 27%, and 19%, respectively.The estimated overall survival rates at 5, 10, and 15 years were 86%, 78%, and 55%, respectively.Multivariate analysis revealed that male gender was an independent poor prognostic factor for RFS [hazard ratio (HR): 2.11, 95% confidence interval (CI): 1.15-3.86]and for distant-metastasis-free survival (HR: 2.79, 95% CI: 1.41-5.56).Despite aggressive treatment, more than one-third of patients experience distant recurrence during follow-up. Conclusion:Our study identified male gender as an independent predictor of poor prognosis in patients who underwent primary curative surgery.