Author(s)
Tyler J. Gallagher, BS
Matthew E. Lin, BS
Niels C. Kokot, MD
Affiliation(s)
University of Southern California Keck School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand epidemiologic trends in adenoid cystic carcinoma (ACC).
Objectives: Adenoid cystic carcinoma (ACC) is a rare tumor with uniquely indolent but aggressive behavior. We utilized a database of electronic medical record data to understand updated epidemiologic trends in ACC.
Study Design: Cross-sectional study.
Methods: Data from patients with ACC were extracted from the TriNetX database. Demographics, tumor characteristics, and common comorbidities were analyzed with descriptive statistics. Kaplan-Meier curves described 5 and 10 year survival rate. Analysis of survival rate based on tumor stage and treatment type was compared between cohorts after propensity score matching.
Results: Our cohort included 616 patients with ACC with mean age 70 (SD:15) and majority being female (58.6%), white (71.8%), and not Hispanic or Latino (58.6%). Rates of several comorbid diagnoses were higher in the ACC group compared to all ICD-10 diagnosis group, including hypertensive disease (p<0.001), gastroesophageal reflux disease (p<0.001), hyperlipidemia (p<0.001), hypothyroidism (p<0.001), depressive episode (p<0.001), and other anxiety disorders (p<0.001), but not diabetes mellitus, type 2 (p=0.624). Most common TNM stages at diagnosis included summary stage 4 (94, 40.7%), T4 (90, 29.8%), N0 (170, 59.9%), and M0 (170, 90.9%). 5 and 10 year survival rates were 82.8% and 75.9%, respectively. Tumor stage (OR:1.13, 95% CI: [0.43 - 2.91]) and use of radiation and surgery compared to surgery alone (OR:1.21, 95% CI: [0.51 - 2.88]) did not significantly alter survival.
Conclusions: ACC was found to present most commonly in later stages but with relatively high 5 and 10 year survival. This study did not find effects on survival based on stage at diagnosis or adjuvant radiation, underscoring the uniquely slow but aggressive growth of this malignancy.