Lung metastasectomy in adenoid cystic cancer: Is it worth it?

Abstract

BACKGROUND AND PURPOSE:

Adenoid cystic carcinoma (ACC) of salivary glands is characterized by long-term distant metastasis, most commonly in lungs. No agreement has been reached about the role of surgical treatment of pulmonary lesions. We evaluated the long-term results of lung metastasectomy for ACC in order to identify factors that should be taken into account in selecting patients eligible for surgery and treatment planning.

PATIENTS AND METHODS:

A retrospective study was conducted on 109 patients selected from our institutional experience and from the International Registry of Lung Metastases. Survival was calculated by Kaplan-Meier estimate and prognostic factors endowed with a predictive power for most other metastatic cancers were investigated.

RESULTS:

The cumulative survival was 66.8% at 5years and 40.5% at 10years. In patients with a disease-free interval (DFI) greater than 36months, the overall survival was 76.5% at 5years. Survival in case of complete surgical resection was 69.5% at 5years. Multivariate analysis confirmed DFI and completeness of resection resulted in the best prognostic variables.

DISCUSSION:

Lung metastasectomy should be considered as a therapeutic option to achieve local control of disease when 2 conditions are met: (1) complete surgical resection is feasible and (2) the time to pulmonary relapse after primary tumor treatment is greater than 36months. Symptomatic benefits of an incomplete lung resection in slow-growing tumors such as ACC remain uncertain. The turning point in the management of disseminated cancers will be clarified with biological profiling of ACC and the development of targeted therapies.

• Authors: Lara Girelli, Laura Locati, Carlotta Galeone, Paolo Scanagatta, Leonardo Duranti, Lisa Licitra, Ugo Pastorino
• Journal: Oral oncology (Oral Oncol) Vol. 65 Pg. 114-118 (02 2017) ISSN: 1879-0593 [Electronic] England
• PMID: 28341276 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Topics

• Carcinoma, Adenoid Cystic (pathology)
• Female
• Humans
• Lung Neoplasms (secondary, surgery)
• Male
• Middle Aged
• Retrospective Studies
• Salivary Gland Neoplasms (pathology)