Evaluation of survival outcomes and prognostic factors in acinic cell carcinomas of the parotid gland receiving adjuvant radiotherapy

Year 2022, Volume: 4 Issue: 3, 290 - 294, 26.07.2022

Mursel Duzova , Mustafa Akın

https://doi.org/10.38053/acmj.1124201

Abstract

Aim: To evaluate the survival outcomes and prognostic factors in acinic cell carcinoma of the parotid gland, a retrospective study was designed.
Material and Method: Consecutive patients diagnosed with parotid acinic cell carcinoma and treated with surgery and adjuvant radiotherapy were retrospectively reviewed. Data regarding age, sex, TNM stage, pathologic characteristics, treatment details, and follow-up examinations were collected and analysed. The primary end-point was overall survival; the distant metastasis free survival was calculated from the date of surgery to the date of death or the latest follow-up examination and analysed by the Kaplan-Meier method. Independent prognostic factors were evaluated by the Cox proportional hazards method.
Results: Between years of 2010-2020, two radiotherapy centers’ database were reviewed. A total of 32 patients were included. The median age was 55 years (35-80 years). Four-teen (43.75%) were male and 18 (56.25%) were female. Median follow-up was 44 months (8-120). Seven (21.9%) were in T1, 7 (21.9%) in T2, 6 (18.8%) in T3 and 12 (37.5%) in T4 at the time of diagnosis. In all cohort, 6 (18.8%) of them had lymph node metastasis. The 2-year and 5-year OS rates were 92.6% and 78.5%, locoregional recurrence-free survival rates were 100% and 89.1%, distant metastasis free survival rates were 85.9% and 85.9%, respectively. Locoregional recurrence detected in 2 (6.25%), distant metastases detected in 4 (12.5%) patients. All distant metastases detected in the lungs. Univariate analysis showed that age, gender, margin status, T stage, facial nerve involvement, lymphovascular invasion, and perineural invasion were not significantly related to overall survival (all p>0.05). Lymph node involvement (p<0.013) and grade (p<0.006) were the only significant prognostic factors for OS. In multivariate analysis, both lymph node involvement (p<0.050) and grade (p<0.028) remained the significant prognostic factors.
Conclusion: In acinic cell carcinoma of the parotid gland, high-grade histology and node positivity are independent variables that affect OS. Since survival is lower in these patient groups, it is imperative to explore other treatment options in addition to adjuvant radiotherapy.

Keywords

Parotid cancer, acinic cell carcinoma, prognostic factors, radiotherapy, survival

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