Stawarz K, Gorzelnik A, Klos W, Korzon J, Kissin F, Bienkowska-Pluta K, Stawarz G, Rusetska N, Zwoliński J. Prognostic value of clinicopathological parameters in adenoid cystic carcinoma: A retrospective cohort study. World J Clin Oncol 2026; 17(4): 116329 [DOI: 10.5306/wjco.v17.i4.116329]
Corresponding Author of This Article
Katarzyna Stawarz, MD, Department of Head and Neck Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, W. K. Roentgen 5, Warsaw 02-781, Mazowieckie, Poland. katarzyna.stawarz@nio.gov.pl
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Oncology
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Retrospective Cohort Study
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Apr 24, 2026 (publication date) through Apr 22, 2026
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World Journal of Clinical Oncology
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Stawarz K, Gorzelnik A, Klos W, Korzon J, Kissin F, Bienkowska-Pluta K, Stawarz G, Rusetska N, Zwoliński J. Prognostic value of clinicopathological parameters in adenoid cystic carcinoma: A retrospective cohort study. World J Clin Oncol 2026; 17(4): 116329 [DOI: 10.5306/wjco.v17.i4.116329]
World J Clin Oncol. Apr 24, 2026; 17(4): 116329 Published online Apr 24, 2026. doi: 10.5306/wjco.v17.i4.116329
Prognostic value of clinicopathological parameters in adenoid cystic carcinoma: A retrospective cohort study
Katarzyna Stawarz, Anna Gorzelnik, Wojciech Klos, Jacek Korzon, Filip Kissin, Karolina Bienkowska-Pluta, Grzegorz Stawarz, Natalia Rusetska, Jakub Zwoliński
Katarzyna Stawarz, Anna Gorzelnik, Wojciech Klos, Jacek Korzon, Filip Kissin, Karolina Bienkowska-Pluta, Jakub Zwoliński, Department of Head and Neck Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw 02-781, Mazowieckie, Poland
Grzegorz Stawarz, Department of Urology, Warsaw Praski Hospital, Warsaw 03-401, Mazowieckie, Poland
Natalia Rusetska, Department of Experimental Immunology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw 02-781, Mazowieckie, Poland
Author contributions: Stawarz K, Gorzelnik A, Klos W, Bienkowska-Pluta K, Stawarz G and Rusetska N conceptualized the study; Stawarz K, Gorzelnik A, Korzon J, Kissin F, and Stawarz G curated the data; Stawarz K and Stawarz G wrote the original draft; Stawarz K, Stawarz G and Rusetska N developed the methodology; Gorzelnik A, Klos W, Korzon J, Kissin F, Bienkowska-Pluta K, Rusetska N and Zwoliński J reviewed and edited the manuscript; Gorzelnik A, Rusetska N, and Zwoliński J performed the investigation; Zwoliński J supervised the study; all authors have read and agreed to the final version of the manuscript.
Institutional review board statement: The Ethics Committee of the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, waived the need for ethics approval.
Informed consent statement: Informed consent for the information published in this article was not required, as it was waived by the Ethics Committee of the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: All data supporting the findings of this study are available upon reasonable request from the corresponding author.
Corresponding author: Katarzyna Stawarz, MD, Department of Head and Neck Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, W. K. Roentgen 5, Warsaw 02-781, Mazowieckie, Poland. katarzyna.stawarz@nio.gov.pl
Received: November 11, 2025 Revised: November 21, 2025 Accepted: January 26, 2026 Published online: April 24, 2026 Processing time: 164 Days and 13.7 Hours
Abstract
BACKGROUND
Adenoid cystic carcinoma (ACC) is a rare malignant tumor of the salivary glands, characterized by slow progression, perineural invasion, and a high rate of late recurrence. Despite surgical resection being the mainstay of treatment, prognostic factors influencing long-term outcomes remain unclear due to limited data and disease rarity. Understanding these factors is essential for optimizing therapeutic strategies and improving survival. This study was conducted to identify clinicopathologic variables associated with overall survival (OS) and disease-free survival (DFS) in patients with surgically treated ACC. Hypothesis: Advanced stage and adverse pathologic features predict poorer survival outcomes.
AIM
To evaluate clinicopathologic prognostic factors influencing OS and DFS in patients undergoing surgery for ACC.
METHODS
This retrospective cohort study included 55 patients with histologically confirmed ACC treated surgically at a tertiary referral center between 1997 and 2024. Demographic, clinical, and pathological data were collected and correlated with OS and DFS. Survival analysis was performed using Kaplan-Meier estimates, and prognostic factors were evaluated by Cox proportional hazards regression. Postoperative radiotherapy (PORT) and chemotherapy use were recorded to assess their impact on outcomes.
RESULTS
The cohort comprised 35 females (63.6%) and 20 males (36.4%) with a mean age of 59.5 ± 13.1 years. Primary sites included salivary glands (67.3%) and sinonasal or tracheal regions (32.7%). PORT was delivered to 34 patients (61.8%), and adjuvant chemotherapy to 5 patients (9.1%). Over a median follow-up of 42 months, 16 patients (29.1%) developed recurrence, and 24 (43.6%) died of disease. Univariate analysis identified advanced T stage, positive margins, and perineural invasion as predictors of worse OS and DFS (all P < 0.05). Multivariate analysis confirmed T stage (hazard ratio = 3.45, P = 0.018) and margin status (hazard ratio = 2.87, P = 0.042) as independent prognostic factors.
CONCLUSION
Advanced T stage and positive surgical margins independently predict poorer survival in ACC. Achieving negative margins and incorporating PORT remain essential for optimal curative outcomes.
Core Tip: This study identifies key prognostic factors influencing survival in patients with adenoid cystic carcinoma following surgical treatment. Among 55 patients analyzed, advanced T stage and positive surgical margins independently predicted poorer overall and disease-free survival. Postoperative radiotherapy showed a protective trend, suggesting benefit for local control and long-term outcomes. These findings emphasize the critical importance of achieving negative margins during surgery and integrating radiotherapy into the treatment strategy. By clarifying prognostic determinants, this study contributes valuable evidence to guide individualized, curative management of adenoid cystic carcinoma and improve patient survival in this rare malignancy.
