2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook
C.
Sua´rez
et
al.
/ Auris Nasus
Larynx
43
(2016)
477–484
grade
diagnosis of head
and neck AdCC
is
variable
depending
on
the
transformation
(AdCC-HGT)
have
been
recognized
in
site of origin of
the
tumor but usually
ranges between
literature
to
date
[30–32] .
AdCC-HGT
is
a
highly
series and
the
and 16% reasons
[1,2,4–6,8,10–13,15–20,22–29]
( Table
4 ). One
of
tumor
with
a
strong
tendency
to
recur
and
3% the
aggressive metastasize
that rare
overall
reported
occurrence
of
lymph
node
to
regional
lymph
nodes
(57%
in
the
review
of
is
for AdCC
from different published
series may
et
al.
[31] )
and
to
distant
organs.
metastasis
Seethala
be
Min
that
the
two most
common
sites
for AdCC,
the parotid gland
et
al.
[12]
reported
that
minor
salivary
gland
AdCC
hard
palate,
have
low
propensity
for
nodal
spread.
Thus,
to only one neck
level
in almost 60% of cases. For
and Min
metastasized
et
al.
[12]
studied
616
cases
of
head
and
neck
AdCC,
remaining
patients,
cervical
lymph
node
metastasis
was
the
62
(10%)
cases
of AdCC with
cervical
lymph
node
two or more
levels. Level
II was
the most
frequently
identifying
reported at
the
time of surgery and 24 cases with
late
a
reported
incidence
of
59.6%. Level
III
and
IV
metastasis, 38 cases at
involved, with regions were
after
initial
surgery.
When
primary
sites
were
affected
only
in
22.5%
of
cases.
recurrence compared,
the
reported
incidence
of
cervical metastases
was
recurrence can occur after
treatment
in 0–14% of
Neck node
when
primary
tumor
sites
were
located
at
the
base
of
salivary glands,
and
is highly dependent on
the
higher tongue
AdCC of minor
extent
(19.2%),
followed
by
the mobile
tongue
(17.6%)
and
of
the
treatment.
It
is
very
rare
in
patients who
received postoper-
of mouth primary
(15.3%),
whereas
the
incidence
of metastasis
or
elective
neck
dissections
[1,10,20] ,
or
floor from
therapeutic
tumors
of
the
hard
palate
was
only
8%.
The
radiotherapy
(RT)
to
the
neck with
[8,18] .
ative
for
the high
incidence
from
tongue base primary
tumors
node
involvement
or
without
extracapsular
reason
Lymph
be
due
to
their
advanced network
stage
at
presentation,
and
the
at diagnosis
in AdCC has been
shown
in most
reports
to
may
spread
lymphatic
in
this
site.
The
incidence
of
independently
associated with
decreased
overall
and
cause-
extensive clinically
be
positive nodes
(cN+)
for
intraoral
and oropharyngeal
survival
[6,8,12–17,19,27,33–35] . Kakarala
and Bhat-
specific
varies
from
2%
to
43% [4,5,12,20,23] ,
and
is
low
for
[36]
reported
that N
status
correlated with
a
higher
AdCC
tacharyya
AdCC of
odds
the palate and high
for base of
the
tongue
localizations
ratio
for
poor
survival,
indicating
the
importance
of
metastasis
in
determining
prognosis
in
oral
cavity
[5,12,23] . Dedifferentiation and/or high-grade
regional
transformation has been
salivary
gland
tumors.
Bianchi
et to
al.
[20]
observed
a
minor
in
a
variety
of
salivary
gland
carcinomas,
including
survival
difference
according
regional
metastasis
described AdCC. A
distinct
total
of
approximately
40
cases
of AdCC with
high
in
oral minor
salivary
gland AdCC.
In
their
study,
5,
10,
status
survival
rates were 44.4%
in patients with
regional
and 15-year metastasis,
compared
to 79.1%, 76.9%, and 76.9%
respectively
patients without
regional metastasis. Furthermore, Lee et al.
in
Table 4 Incidence
[10]
recorded,
among
61
cases
of
head
and
neck
AdCC,
an
rate
of
clinical
neck metastases
and
neck
recurrences.
survival
rate of 85% at 5 years, 81.1% at 10 and 15 years
overall
Clinical N+ Oral/ oropharynx (%)
Neck recurrence (%)
No.
Clinical N+ HN AdCC
patients with
negative
status
(N-), whereas
in
patients with
in
status
(N+),
the
survival Finally,
rate was Oplatek
56.8%
at
5
years have
positive N
(%)
28.4%
at
10
years.
et
al.
[13]
and
from
a
cohort
of
113
cases
of
head
and
neck AdCC
reported,
et
al.
[1]
38
6 7
(15.8)
4
(10.5) (17.5)
Lee
regional cervical
lymph node metastasis at
the
that patients with
et
al.
[2]
103
(6.8)
18
Jones
et
al.
[4]
16 48
1 1
(6.3) (2.1)
0
Iyer
of
diagnosis
had
a mean
survival
of
46 months
compared
time
et
al.
[5] al.
Li
to
a mean
survival
of
98 months
for
those without
evidence
of
et
[6]
2286 183
(8)
Lloyd
regional metastasis. Lymphovascular
et
al.
[8]
59 61 76
9 4
(15) (6.5)
4
(7)
Gomez
invasion
usually
precedes
spread
to
the
et
al.
[10]
Lee
nodes
that
drain
the
tissue
in which
the
tumor
arose. On
lymph
et
al.
[11]
6
(7.9)
5
(6.5) (3.9)
Agarwal
et
al.
[12]
616 38
(6.2) (7.1)
24
Min
analysis,
lymphovascular
invasion
was
the
only
multivariate prognostic
et
al.
[13]
99
7
Oplatek
factor
for
overall
survival
[1]
and
was
also
an
Cruz
Perez
129 13
(10.1)
2
(2.8)
da
independent predictor of recurrence [13,37] . Other
tumor-related
[15] a
al.
et
factors
independently
associated
with
decreased
histologic
et
al.
[16]
160
2
(1.2)
Fordice
survival
are
perineural
involvement
of
a
major
nerve
[8,24]
et
al.
[17]
105 11
(10)
vanWeert Balamucki Anderson
et
al.
[18]
120
7 2
(6) (5)
0
solid
histological
subtype
of AdCC
[16,17,21,30,35] .
and
et
al.
[19]
41 67
authors
have
found
that
lymph
node
involvement
is
a
Most
et
al.
[20]
6
(9)
Bianchi
factor
for
subsequent
distant metastasis
[1,6,27,38] . Thus,
risk
et
al.
[22]
495 44
(8.9)
Amit
to Ko
et
al.
[14]
75%
of
patients with
initial
nodal Even node
according
et
al.
[23]
14
6
(43)
Namazie
eventually
developed
distant
metastasis.
involvement considering metastases
et
al.
[24]
198
6
(3) (7)
6
(3)
Garden
et
al.
[25]
242 17
18
(7.4)
Spiro
only
the
presence
of
histologic
lymph
et
al.
[26]
50
5
(10) (13)
2
(4)
Ettl
in ENDs, Amit et al.
[22] pointed out
that
the 5-year
et
al.
[27]
151 20
Douglas
distant metastasis
rate was
significantly
higher
among
patients
55
1
(2)
Armstrong et al.
than among
those without
(40% and 27%,
with nodal metastasis
[28]
respectively). The
et
al.
[29]
50
8
(16)
Sur
characteristics
of
lymph
node metastasis
as
related
to
HN,
head
and
neck; AdCC,
adenoid
cystic
carcinoma.
a Includes
in AdCC have been
studied
the occurrence of distant metastasis
only
isolated
neck metastasis.
29
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