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Predictors of Morbidity and Mortality

Jim Fordice, MD; Corey Kershaw, MS; Adel El-Naggar, MD; Helmuth Goepfert, MD

Arch Otolaryngol Head Neck Surg. 1999;125:149-152.

Objectives  To review 160 patients treated at a single institution for adenoid cystic carcinoma during the 20 years between 1977 and 1996, applying a consistent treatment of surgery and postoperative radiation therapy to 140 patients. To analyze factors governing treatment failure, treatment-related morbidity, and mortality.

Design  Retrospective review.

Setting  Tertiary referral center.

Patients  Seventy-seven males and 83 females aged 13 to 89 years (average age, 49.5 years).

Results and Conclusions  Combined treatment yielded an 85% locoregional freedom from relapse and disease-specific survival at 5, 10, and 15 years was 89%, 67.4%, and 39.6%, respectively. Thirty-five patients (21.9%) had distant metastases as the only site of failure. Patients treated for paranasal sinus tumor experienced the most treatment-related morbidity vs other sites. Perineural invasion of major nerves, positive margins at surgery, and solid histological features were associated with increased treatment failures. Four or more symptoms present at diagnosis, positive lymph nodes, solid histology, and perineural invasion of major nerves were associated with increased mortality from disease.

From the Departments of Head and Neck Surgery (Drs Fordice and Goepfert) and Surgical Pathology (Dr El-Naggar), University of Texas M.D. Anderson Cancer Center and Univesity of Texas Health Science Center (Ms Kershaw), Houston.

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