Prognostic value of clinicopathological parameters in adenoid cystic carcinoma: A retrospective cohort study

Table 1 Patient characteristics, n (%)/mean ± SD/mean (range)

Variable
Total patients	55
Age (years)	59.5 ± 13.1
Sex
Female	35 (63.6)
Male	20 (36.4)
Postoperative radiotherapy	34 (61.8)
Mean total dose (Gy)	62 (60-66)
Adjuvant chemotherapy	5 (9.1)
Recurrence (local or distant)	16 (29.1)
Most frequent metastasis site	Lung
Status at last follow-up (August 2025)
Alive (with/without recurrence)	31 (56.4)
Died of disease	24 (43.6)
Follow-up duration (months)	Median = 89.4; mean = 94.7 ± 69.6 (0.9-306.6)

Table 2 Tumor and pathologic characteristics, n (%)

Tumor location		Tumor characteristics
Maxillary sinus	13 (23.6)	Perineural invasion positive	40 (72.7)
Submandibular gland	8 (14.5)	Margin positive (+)	35 (63.6)
Parotid gland	8 (14.5)	Margin negative (-)	20 (36.4)
Lung	4 (7.3)	Resection type R0	20 (36.4)
Sublingual gland	3 (5.5)	Resection type R1	33 (60.0)
Tonque	3 (5.5)	Resection type R2	2 (3.6)
Base of skull	3 (5.5)	T1	10 (18.2)
Floor of the mouth	2 (3.6)	T2	10 (18.2)
Soft palate	2 (3.6)	T3	11 (20.0)
Lower lip	2 (3.6)	T4	24 (43.6)
Orbit	2 (3.6)	N0	43 (78.2)
Brain	1 (1.8)	N1	4 (7.3)
Cheek mucosa	1 (1.8)	N2	8 (14.5)
Hard palate	1 (1.8)	N3	0 (0.0)
Pterygopalatine fossa	1 (1.8)	M0	37 (67.2)
Ethmoid sinus	1 (1.8)	M1	18 (32.8)

Table 3 Clinicopathological assessment

Comparison	P value (χ2)
PNI (+) vs margin status	0.028
PNI (+) vs resection type (R0 vs R1/R2)	0.041
PNI (+) vs T stage (T1-T4)	0.033
Margin status vs recurrence	0.046
T stage vs recurrence	0.021
T stage vs metastasis (M stage)	0.037
N stage vs recurrence	0.38
N stage vs metastasis	0.44
Tumor location vs PNI	0.048
Tumor location vs recurrence	0.048
Solid subtype vs recurrence	0.031
Solid subtype vs disease-related death	0.045

PNI: Perineural invasion.

Table 4 Clinical-outcome correlations, n (%)/mean ± SD

Variable	Recurrence (n = 16)	No recurrence (n = 39)	P value	Deaths (n = 24)	Alive (n = 31)	P value
Age (years)	61.3 ± 11.9	59.8 ± 12.4	0.44	57.8 ± 14.0	60.8 ± 12.5	0.37
Sex
Male (n = 20)	6 (30.0)	14 (70.0)	0.61	9 (45.0)	11 (55.0)	0.58
Female (n = 35)	10 (28.6)	25 (71.4)		14 (40.0)	21 (60.0)
Margins
R0 (n = 38)	8 (21.1)	30 (78.9)	0.038	12 (31.6)	26 (68.4)	0.033
R1/R2 (n = 17)	8 (47.1)	9 (52.9)		11 (64.7)	6 (35.3)
Perineural invasion
Absent (n = 13)	2 (15.4)	11 (84.6)	0.041	3 (23.1)	10 (76.9)	0.026
Present (n = 42)	14 (33.3)	28 (66.7)		20 (47.6)	22 (52.4)
T stage
T1 and T2 (n = 23)	4 (17.4)	19 (82.6)	0.029	6 (26.1)	17 (73.9)	0.018
T3 and T4 (n = 32)	12 (37.5)	20 (62.5)		17 (53.1)	15 (46.9)
N stage
N0 (n = 40)	10 (25.0)	30 (75.0)	0.21	15 (37.5)	25 (62.5)	0.24
N+ (n = 15)	6 (40.0)	9 (60.0)		8 (53.3)	7 (46.7)
M stage
M0 (n = 49)	13 (26.5)	36 (73.5)	0.17	19 (38.8)	30 (61.2)	0.14
M1 (n = 6)	3 (50.0)	3 (50.0)		4 (66.7)	2 (33.3)
Postoperative radiotherapy
Yes (n = 34)	7 (20.6)	27 (79.4)	0.031	11 (32.4)	23 (67.6)	0.040
No (n = 21)	9 (42.9)	12 (57.1)		12 (57.1)	9 (42.9)
Chemotherapy
Yes (n = 5)	2 (40.0)	3 (60.0)	0.48	3 (60.0)	2 (40.0)	0.51
No (n = 50)	14 (28.0)	36 (72.0)		20 (40.0)	30 (60.0)

Table 5 Cox proportional hazards regression analysis of prognostic factors in adenoid cystic carcinoma, hazard ratio (95%CI)

Variable	Univariate	P value	Multivariate	P value
Recurrence-free survival
Advanced T stage (T3 and T4 vs T1 and T2)	3.89 (1.21-9.85)	0.021	3.46 (1.21-9.85)	0.021
Positive margins (R1/R2 vs R0)	2.84 (1.09-7.42)	0.032	2.84 (1.09-7.42)	0.032
PNI (present vs absent)	2.67 (1.01-7.09)	0.047	2.12 (0.91-6.03)	0.081
PORT (yes vs no)	0.57 (0.24-1.31)	0.182	0.57 (0.24-1.31)	0.182
Overall survival
Advanced T stage (T3 and T4 vs T1 and T2)	4.12 (1.39-12.20)	0.011	3.28 (1.18-9.11)	0.023
Positive margins (R1/R2 vs R0)	3.01 (1.08-8.39)	0.035	2.71 (1.01-7.29)	0.048
PNI (present vs absent)	2.74 (1.02-7.35)	0.044	2.31 (0.89-6.04)	0.075
PORT (yes vs no)	0.49 (0.21-1.12)	0.094	0.52 (0.24-1.15)	0.096

PNI: Perineural invasion; PORT: Postoperative radiotherapy.

Table 6 Comparison of clinicopathologic characteristics and 5-year disease-free survival between major and minor salivary gland tumors, mean ± SD

Variable	Major salivary glands (n = 19)	Minor salivary glands (n = 36)	P value
Age (years)	60.9 ± 12.7	58.7 ± 13.5	0.55
Perineural invasion (%)	78.9	69.4	0.54
Positive surgical margins (%)	68.4	58.3	0.66
5-year disease-free survival (%)	57.9	52.8	0.41