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Clinical analysis of sinonasal adenoid cystic carcinoma

Other Titles
 비부비동 선양낭성암종의 임상적 분석 
 Dept. of Otorhinolaryngology (이비인후과학교실) 
Issue Date
Dept. of Medicine/석사
Adenoid cystic carcinoma is a rare sinonasal malignancy. Thus, many cases of adenoid cystic carcinoma have been integrated and reported with other adenoid cystic carcinomas of head and neck origin. General features of adenoid cystic carcinoma are slow progression, frequent multiple recurrences after treatment, and frequent local recurrence and distant metastasis after a long time. Although adenoid cystic carcinoma tends to metastasize to distant organs, it is known to have relatively long survival period. However, studies focusing on sinonasal adenoid cystic carcinoma are lacking owing to its low incidence. We therefore retrospectively reviewed 30 cases of sinonasal adenoid cystic carcinoma to identify its clinical features and prognostic factors. The median age of the patients from this study was 54.1 years. The 5-year overall survival rate and disease-free survival rate were 75.3% and 37.2%, respectively. The maxillary sinus (63.3%) and nasal cavity (23.3%) were the most common sites of primary tumor. The majority of patients were diagnosed with advanced disease (stage III/IV, 80.0%). The most common histopathological subtype was cribriform type adenoid cystic carcinoma (40.9%). Almost all patients (70.0%) underwent surgery and postoperative radiotherapy. The total recurrence rate was 53.3%, and the local and distant recurrence rates were 26.7% and 23.3%, respectively. The mean duration until recurrence from diagnosis was 44.5 months. Advanced clinical stage and T stage had the worst survival. Positive resection margin and skull base invasion seemed to be poor prognostic factors, but not statistically proven. Local recurrence had worse overall survival than distant recurrence, and distant metastasis did not affect the overall survival even with frequent distant recurrences. This demonstrates that sinonasal adenoid cystic carcinoma has a long-term survival rate after distant metastasis, and effective local treatment and early diagnosis seem to be most important for the long-term survival.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 2. Thesis
Yonsei Authors
Seong, Sang Yeob(성상엽)
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