Adenoid cystic carcinoma of salivary glands : diagnostic and prognostic factors and treatment outcome

Research output: ThesisDoctoral ThesisCollection of Articles

Abstract

Patients suffering from adenoid cystic salivary gland carcinoma have variable prognosis and longterm follow up is recommended In 35 years follow up it was noted that of those patients suffering from adenoid cystic carsinoma (ACC) of salivary glands, 54% of major salivary glands and 42% of minor salivary glands carcinoma patients were alive 10 years after treatment. One factor that significantly worsened the survival was distant metastases appearing during the follow up. They appeared in 50% of major- and 34% of minor salivary glands cancer patients, most commonly in lungs. Almost all distant metastases appeared within 10 years after treatment. It is thus recommended to actively follow up ACC-patients at least 10 years after treatment. Some ACC-patients however live long and therefore the risk of ACC and other salivary gland cancer patients developing second primary cancer during their lifetime was investigated in this study. The risk was 43% higher compared to the cancer risk of general population. The risk was most elevated for thyroid cancer, but the risk for melanoma of the skin, other skin cancers, cancers of breasts, respitarory organs and male genital organs was also significantly higher. The risk was higher during the the first 5 years and then again 20 years after salivary gland cancer diagnosis. Prolonged follow-up time in primary health care center is warranted as early detection of second primary cancer may prolong the survival. The role of Toll-like receptors (TLRs) 5 and 7 in ACC was also investigated in this study as TLR expression is known to correlate with survival in many cancers. In this immunohistochemical study TLR 5 and 7 were shown to also express in ACC but there was no direct correlation to survival. The materials for this study were patient records and tumor samples of patients with major salivary gland ACC treated between 1974-2014 and minor salivary gland ACC treated between 1974-2014 in Helsinki University Hospital district area. During this time period there were 54 major- and 68 minor salivary gland ACC patients. The data from Finnish Cancer Registry between 1953-2014 were used in the study investigating the second primary cancers. During this time period there were 1727 salivary gland carcinoma patients of which 222 developed second primary cancer. Aim of this study was to asses the factors that determine the long term outcome of ACC patients as well as to investigate the risk of salivary gland carcinoma patients to develop second primary cancer. In Finland approximately 60 new salivary gland cancer patients appear annually, approximately one third of these are ACCs. Main treatment modality is surgery followed by post operative radiotherapy in some cases. Treatment or survival have not markedly changed during the years. Distant metastases are more common than neck metastases or local recurrences. Molecular biology of ACC is under active research in order to find new prognostic markers and treatment protocols.
Original languageEnglish
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-3727-2
Electronic ISBNs978-951-51-3728-9
Publication statusPublished - 2017
MoE publication typeG5 Doctoral dissertation (article)

Fields of Science

  • 3125 Otorhinolaryngology, ophthalmology
  • 3122 Cancers

Cite this

@phdthesis{5a9d05d3cb2d4c569f6df11c95483343,
title = "Adenoid cystic carcinoma of salivary glands : diagnostic and prognostic factors and treatment outcome",
abstract = "Patients suffering from adenoid cystic salivary gland carcinoma have variable prognosis and longterm follow up is recommended In 35 years follow up it was noted that of those patients suffering from adenoid cystic carsinoma (ACC) of salivary glands, 54{\%} of major salivary glands and 42{\%} of minor salivary glands carcinoma patients were alive 10 years after treatment. One factor that significantly worsened the survival was distant metastases appearing during the follow up. They appeared in 50{\%} of major- and 34{\%} of minor salivary glands cancer patients, most commonly in lungs. Almost all distant metastases appeared within 10 years after treatment. It is thus recommended to actively follow up ACC-patients at least 10 years after treatment. Some ACC-patients however live long and therefore the risk of ACC and other salivary gland cancer patients developing second primary cancer during their lifetime was investigated in this study. The risk was 43{\%} higher compared to the cancer risk of general population. The risk was most elevated for thyroid cancer, but the risk for melanoma of the skin, other skin cancers, cancers of breasts, respitarory organs and male genital organs was also significantly higher. The risk was higher during the the first 5 years and then again 20 years after salivary gland cancer diagnosis. Prolonged follow-up time in primary health care center is warranted as early detection of second primary cancer may prolong the survival. The role of Toll-like receptors (TLRs) 5 and 7 in ACC was also investigated in this study as TLR expression is known to correlate with survival in many cancers. In this immunohistochemical study TLR 5 and 7 were shown to also express in ACC but there was no direct correlation to survival. The materials for this study were patient records and tumor samples of patients with major salivary gland ACC treated between 1974-2014 and minor salivary gland ACC treated between 1974-2014 in Helsinki University Hospital district area. During this time period there were 54 major- and 68 minor salivary gland ACC patients. The data from Finnish Cancer Registry between 1953-2014 were used in the study investigating the second primary cancers. During this time period there were 1727 salivary gland carcinoma patients of which 222 developed second primary cancer. Aim of this study was to asses the factors that determine the long term outcome of ACC patients as well as to investigate the risk of salivary gland carcinoma patients to develop second primary cancer. In Finland approximately 60 new salivary gland cancer patients appear annually, approximately one third of these are ACCs. Main treatment modality is surgery followed by post operative radiotherapy in some cases. Treatment or survival have not markedly changed during the years. Distant metastases are more common than neck metastases or local recurrences. Molecular biology of ACC is under active research in order to find new prognostic markers and treatment protocols.",
keywords = "Biomarkers, Tumor, +analysis, Carcinoma, Adenoid Cystic, +metabolism, +mortality, +pathology, +therapy, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasms, Second Primary, Prognosis, Risk Assessment, Salivary Gland Neoplasms, Survival Analysis, Toll-Like Receptors, Treatment Outcome, 3125 Otorhinolaryngology, ophthalmology, 3122 Cancers",
author = "Karoliina Hirvonen",
note = "M1 - 67 s. + liitteet",
year = "2017",
language = "English",
isbn = "978-951-51-3727-2",
series = "Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis",
publisher = "Helsingin yliopisto",
number = "59/2017",
address = "Finland",

}

Adenoid cystic carcinoma of salivary glands : diagnostic and prognostic factors and treatment outcome. / Hirvonen, Karoliina.

Helsinki : Helsingin yliopisto, 2017. 67 p.

Research output: ThesisDoctoral ThesisCollection of Articles

TY - THES

T1 - Adenoid cystic carcinoma of salivary glands : diagnostic and prognostic factors and treatment outcome

AU - Hirvonen, Karoliina

N1 - M1 - 67 s. + liitteet

PY - 2017

Y1 - 2017

N2 - Patients suffering from adenoid cystic salivary gland carcinoma have variable prognosis and longterm follow up is recommended In 35 years follow up it was noted that of those patients suffering from adenoid cystic carsinoma (ACC) of salivary glands, 54% of major salivary glands and 42% of minor salivary glands carcinoma patients were alive 10 years after treatment. One factor that significantly worsened the survival was distant metastases appearing during the follow up. They appeared in 50% of major- and 34% of minor salivary glands cancer patients, most commonly in lungs. Almost all distant metastases appeared within 10 years after treatment. It is thus recommended to actively follow up ACC-patients at least 10 years after treatment. Some ACC-patients however live long and therefore the risk of ACC and other salivary gland cancer patients developing second primary cancer during their lifetime was investigated in this study. The risk was 43% higher compared to the cancer risk of general population. The risk was most elevated for thyroid cancer, but the risk for melanoma of the skin, other skin cancers, cancers of breasts, respitarory organs and male genital organs was also significantly higher. The risk was higher during the the first 5 years and then again 20 years after salivary gland cancer diagnosis. Prolonged follow-up time in primary health care center is warranted as early detection of second primary cancer may prolong the survival. The role of Toll-like receptors (TLRs) 5 and 7 in ACC was also investigated in this study as TLR expression is known to correlate with survival in many cancers. In this immunohistochemical study TLR 5 and 7 were shown to also express in ACC but there was no direct correlation to survival. The materials for this study were patient records and tumor samples of patients with major salivary gland ACC treated between 1974-2014 and minor salivary gland ACC treated between 1974-2014 in Helsinki University Hospital district area. During this time period there were 54 major- and 68 minor salivary gland ACC patients. The data from Finnish Cancer Registry between 1953-2014 were used in the study investigating the second primary cancers. During this time period there were 1727 salivary gland carcinoma patients of which 222 developed second primary cancer. Aim of this study was to asses the factors that determine the long term outcome of ACC patients as well as to investigate the risk of salivary gland carcinoma patients to develop second primary cancer. In Finland approximately 60 new salivary gland cancer patients appear annually, approximately one third of these are ACCs. Main treatment modality is surgery followed by post operative radiotherapy in some cases. Treatment or survival have not markedly changed during the years. Distant metastases are more common than neck metastases or local recurrences. Molecular biology of ACC is under active research in order to find new prognostic markers and treatment protocols.

AB - Patients suffering from adenoid cystic salivary gland carcinoma have variable prognosis and longterm follow up is recommended In 35 years follow up it was noted that of those patients suffering from adenoid cystic carsinoma (ACC) of salivary glands, 54% of major salivary glands and 42% of minor salivary glands carcinoma patients were alive 10 years after treatment. One factor that significantly worsened the survival was distant metastases appearing during the follow up. They appeared in 50% of major- and 34% of minor salivary glands cancer patients, most commonly in lungs. Almost all distant metastases appeared within 10 years after treatment. It is thus recommended to actively follow up ACC-patients at least 10 years after treatment. Some ACC-patients however live long and therefore the risk of ACC and other salivary gland cancer patients developing second primary cancer during their lifetime was investigated in this study. The risk was 43% higher compared to the cancer risk of general population. The risk was most elevated for thyroid cancer, but the risk for melanoma of the skin, other skin cancers, cancers of breasts, respitarory organs and male genital organs was also significantly higher. The risk was higher during the the first 5 years and then again 20 years after salivary gland cancer diagnosis. Prolonged follow-up time in primary health care center is warranted as early detection of second primary cancer may prolong the survival. The role of Toll-like receptors (TLRs) 5 and 7 in ACC was also investigated in this study as TLR expression is known to correlate with survival in many cancers. In this immunohistochemical study TLR 5 and 7 were shown to also express in ACC but there was no direct correlation to survival. The materials for this study were patient records and tumor samples of patients with major salivary gland ACC treated between 1974-2014 and minor salivary gland ACC treated between 1974-2014 in Helsinki University Hospital district area. During this time period there were 54 major- and 68 minor salivary gland ACC patients. The data from Finnish Cancer Registry between 1953-2014 were used in the study investigating the second primary cancers. During this time period there were 1727 salivary gland carcinoma patients of which 222 developed second primary cancer. Aim of this study was to asses the factors that determine the long term outcome of ACC patients as well as to investigate the risk of salivary gland carcinoma patients to develop second primary cancer. In Finland approximately 60 new salivary gland cancer patients appear annually, approximately one third of these are ACCs. Main treatment modality is surgery followed by post operative radiotherapy in some cases. Treatment or survival have not markedly changed during the years. Distant metastases are more common than neck metastases or local recurrences. Molecular biology of ACC is under active research in order to find new prognostic markers and treatment protocols.

KW - Biomarkers, Tumor

KW - +analysis

KW - Carcinoma, Adenoid Cystic

KW - +metabolism

KW - +mortality

KW - +pathology

KW - +therapy

KW - Neoplasm Metastasis

KW - Neoplasm Recurrence, Local

KW - Neoplasms, Second Primary

KW - Prognosis

KW - Risk Assessment

KW - Salivary Gland Neoplasms

KW - Survival Analysis

KW - Toll-Like Receptors

KW - Treatment Outcome

KW - 3125 Otorhinolaryngology, ophthalmology

KW - 3122 Cancers

M3 - Doctoral Thesis

SN - 978-951-51-3727-2

T3 - Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis

PB - Helsingin yliopisto

CY - Helsinki

ER -

Hirvonen K. Adenoid cystic carcinoma of salivary glands : diagnostic and prognostic factors and treatment outcome. Helsinki: Helsingin yliopisto, 2017. 67 p. (Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis; 59/2017).