2025 Proffered Presentations
S319: SINONASAL, NASOPHARYNGEAL, UPPER ORAL AND OROPHARYNGEAL CAVITY ADENOID CYSTIC CARCINOMA: AN INTERNATIONAL MULTI-CENTER RETROSPECTIVE STUDY ON 457 PATIENTS
Gloria Schiavo, MD1; Mario Turri Zanoni1; Davide Mattavelli2; Alessandro Vinciguerra3; Carlo Conti2; Giacomo Gravante1; Ester Orlandi4; Barbara Vischioni4; Benjamin Verillaud3; Yunxia Sarah Guo5; Matt Lechner6; Valerie Lund6; Nathan Creber7; Daniele Borsetto7; Philippe Herman3; Ehab Y Hanna5; Paolo Gm Castelnuovo1; Piero Nicolai8; Marco Ferrari8; 1UNINSUBRIA; 2UNIBS; 3APHP; 4CNAO; 5MD Anderson Cancer Center; 6UCL; 7Cambridge University; 8UNIPD
INTRODUCTION: The study has the following aims: 1) define the best treatment strategy for patients suffering from adenoid cystic carcinoma (ACC) of the sinonasal tract, nasopharynx, upper-oral and upper-oropharyngeal cavity; 2) identify a new definition of recovery for ACC, given its unique behavior.
MATERIAL AND METHODS: Primary or secondary sinonasal, nasopharyngeal, upper oral and oropharyngeal cavity ACCs treated at the hospitals of Padua, Brescia, Paris, Varese, Houston were included. A pseudonymized database was created to collect patient-, treatment- and follow up-related data. A univariate survival analysis was performed in terms of overall survival (OS), disease-specific, progression- and recurrence-free survival (DSS, PFS, RFS). Local treatment strategies were compared to each-other and to the most relevant prognostic variables. Symptoms burden change after retreatment and cumulative incidence of adverse effects were calculated.
RESULTS: The study included 457 patients. The survival analysis demonstrated the prognostic validity of disease stage, grade, treatment intent, residue, response after treatment and margin status. The multivariate analysis demonstrated that cT, cM and Perzin/Szanto grade are independent prognostic factors. The analysis of symptoms burden change after retreatment demonstrated that, mostly, is higher. The cumulative incidence analysis showed that 40% of patients experienced at least one G3/G4 event at 120 months.
CONCLUSIONS: The study demonstrated that: gross total resection w/o adjuvant radiotherapy provides a higher DSS; patients who undergo treatment with a non-curative intent are associated with a worst prognosis; burden of symptoms and toxicity caused by retreatments are considerable despite a limited prognostic gain; local and distant metastases can occur many years after the primary treatment.
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