Data from adult patients with histology-proven ACC from the National Cancer Institute's Surveillance, Epidemiology, and End Results 18 Registries (1973-2011) were analyzed to assess the impact of
lymphadenectomy (≥4 lymph nodes removed) on disease-specific survival (DSS).
RESULTS: Of 1525 patients with ACC, 45% were male. 36, 20, and 44% of patients presented with localized, regional, and distant metastatic diseases, respectively. 8% of patients (n = 67/802) underwent
lymphadenectomy. We observed a higher rate of
lymphadenectomy performed in patients with regional disease [locally advanced
tumors (stage T3 and T4) and/or
lymph node metastasis] and distant
metastasis than in those with localized
tumors (12.4% and 12.0 vs. 5.1, respectively, p < 0.01) and in patients with primary
tumor sizes >10 cm (12.4 vs. 4.2 %, p < 0.01).
Lymph node metastasis was present in 12.8% (19.2% in locally advanced ACC). A
lymphadenectomy was not associated with improved DSS on univariate analysis (p = 0.30), regardless of
tumor size or staging. Independent prognostic factors included: ages ≥60 years (p < 0.01, HR 1.70),
lymph node metastasis (p < 0.01, HR 1.7), distant
metastasis (p < 0.01, HR 5.6), complete resection of
tumor (p < 0.01, HR 0.47), and debulking surgery (p < 0.01, HR 0.49).
CONCLUSION: