Acinic Cell Carcinoma Of The Major Salivary Glands: Analysis Of Prognostic Factors In 2,950 Patients

Acinic cell carcinoma is an uncommon neoplasm of the major salivary glands that is typically categorized as a low-grade tumor. However, certain subsets of patients with this disease have a poor prognosis. The purpose of this study was to better assess the prognostic factors influencing survival, with a focus on patients who might benefit from lymph node dissection and/or adjuvant radiation after primary surgical treatment. The National Cancer Database (NCDB) identified 3,100 cases of acinic cell carcinoma of the major salivary glands for the years 2004-2013. A total of 2,950 cases met inclusion criteria and had primary surgical management with documented treatment course and follow-up data. Kaplan-Meier curves were created to evaluate survival outcomes and multivariate Cox regression analysis was used to identify prognostic factors associated with survival. The 2,857 cases (96.8%) were parotid gland tumors. Of these, 1,960 patients (66.4%) had some extent of regional lymph node sampling, with 453 patients (15.3%) having ≥ 10 lymph nodes removed. A subset of 1,233 patients (41.8%) received postoperative radiation. Kaplan-Meier survival analysis indicated that sex, age, race, insurance status, CDCC comorbidity score, tumor size, lymph node status, and surgical margin status, all had a significant impact on overall survival (P1 positive node hazard ratio 6.320, P1 positive node< 3 cm46%>1 positive node≥ 3 cm36% Open table in a new tab While acinic cell carcinoma is considered a low-grade neoplasm with good overall prognosis, primary tumor size and lymph node involvement have a strong negative impact on survival. This in-depth analysis of various prognostic factors clearly showed these clinical and pathologic factors to be the primary drivers of patient outcomes. This novel observation may be used to help guide patient counseling and overall management of this disease.