Treatment outcomes of sinonasal adenoid cystic carcinoma: 30 cases from a single institution.

Abstract

OBJECTIVE: To establish the clinical features and prognostic factors of sinonasal

adenoid cystic carcinoma (ACC). MATERIAL AND METHODS: Thirty patients with

histopathological diagnosis of sinonasal ACC who were treated at Severance

Hospital between 1990 and 2010 were included in this retrospective chart review

study. RESULTS: The 5-year disease-specific survival and disease-free survival

rates were 75.3% and 37.2%, respectively. The maxillary sinus (63.3%) and nasal

cavity (23.3%) were the most common sites of primary tumour. Most patients were

diagnosed with advanced-stage (III/IV) disease (80.0%) and had undergone surgery

and postoperative radiotherapy (70.0%). The most common histopathological subtype

was cribriform type (40.9%). Local recurrence rate and distant metastasis rates

were 26.7% and 23.3%, respectively. The mean time from primary treatment to

recurrence was 44.5 months. Sinonasal ACC patients with stage IV and T4 disease

had significantly worse survival than those with low stage and T disease.

Patients with local recurrence had worse disease-specific survival than those

with distant recurrence. Distant metastasis was associated with disease-free

survival but not disease-specific survival. CONCLUSION: Despite the frequent

occurrence of distant metastasis, early diagnosis and effective local control

seemed to be the most important factors influencing the survival of sinonasal

ACC.