Clinicopathological factors and prognostic analysis of adenoid cystic carcinomas of sublingual gland: a single-centre retrospective study of 41 patients.

A retrospective review was performed to evaluate the clinicopathological factors and prognosis of patients with sublingual gland adenoid cystic carcinomas (ACC) from January 2007 to December 2023. Forty-one patients were included, 26 women and 15 men (median age 57 years; range 25-76). Surgical excision was performed in all patients, and the occult node metastasis rate was 12.5%. The median overall survival time was 117 months (range 13-147). Twenty-two patients developed recurrent disease after initial surgery. Thirteen patients died due to the tumour during follow-up: distant metastasis was the main cause of death. The 5- and 10-year overall survival (OS) rate were 94.7% and 48.9%, and the 5- and 10-year disease-free survival (DFS) rate were 70.5% and 42.7%, respectively. Male sex (P = 0.042 and P = 0.022), positive surgical margin (P = 0.022 and P = 0.002), AJCC T-classification (P = 0.033 and P = 0.037), AJCC N-classification (P = 0.032 and P<0.001), AJCC TNM-stage (P = 0.014 and P = 0.008) were significantly associated with unfavorable OS and DFS. Multivariate Cox analysis revealed that positive surgical margin was the independent prognostic factor for both OS and DFS, and the grade III histologic type was also the independent prognostic factor for unfavorable OS. The findings confirmed the importance of radical surgical treatment with tumour-free margin in patients with sublingual gland ACC. Patients with positive surgical margin and major nerve invasion had a higher risk of metastatic disease. Elective neck dissection was indicated for patients with advanced stage sublingual gland ACCs.