Adenoid cystic carcinoma of the nasopharynx: 27-year experience.

OBJECTIVE/HYPOTHESIS: Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with special biological features. Clear consensus is not available regarding the clinical characters, management approaches, and prognostic factors. We presented one institution's experience with this tumor and the outcomes of treatment.

STUDY

DESIGN

Retrospective clinical analysis.

METHODS

The medical records of 26 patients with NACC at one institution between 1976 and 2003 were reviewed. Patient records were analyzed for clinical characteristics, management approaches, and outcomes. Survival analysis was performed by Kaplan-Meier method, comparison between groups was performed using log-rank test.

RESULTS

The lymphatic metastases rate and distant metastases rate were 3.8% and 26.9%, respectively. Epstein-Barr virus did not have a close relationship to the incidence of NACC. The 5-year disease free survival rate and overall survival rate (OS) for all patients were 30.3% and 54.8%, respectively. In the stage I, II and III patients, the 5-year OS were 87.5% and 49.4%, respectively in patients treated mainly by combined surgical treatment with radiotherapy and those treated mainly by radiotherapy. Cranial nerves invasion, advanced stage and nonsurgical treatment indicated a significant worse OS, whereas combined surgical treatment was an independent factor affecting disease free survival rate and OS.

CONCLUSIONS

NACC is a malignancy with low rate of lymphatic metastases. NACC should be treated by combined surgical operation and radiotherapy. Cranial nerves invasion, stage and treatment approach might be important factors affecting the prognosis of the patients with NACC.