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.
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Chatelet Florian, Ferrand François Régis, Atallah Sarah, Thariat Juliette, Mouawad François, Fakhry Nicolas, Malard Olivier, Even Caroline, de Monès Erwan, Uro-Coste Emmanuelle, Benzerdjeb Nazim, Hans Stéphane, Testelin Sylvie, Mauvais Olivier, Evrard Diane, Bastit Vianney, Salas Sébastien, Espitalier Florent, Classe Marion, Digue Laurence, Doré Mélanie, Wong Stéphanie, Dupin Charles, Nguyen France, Bettoni Jeremie, Lapierre Ariane, Colin Emilien, Philouze Pierre, Vergez Sébastien, Baujat Bertrand, Herman Philippe, Verillaud Benjamin, REFCOR members
Аннотация
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.