Acinic Cell Carcinoma of the Major Salivary Glands: Analysis of Prognostic Factors in 2,950 Patients

Background: Acinic cell carcinoma (ACC) is an uncommon salivary gland neoplasm. The purpose of this study was to evaluate the prognostic factors that influence survival.

Methods: From the National Cancer Data Base (NCDB), 2,950 cases of ACC of the major salivary glands from 2004-2013 with primary surgical management and documented treatment course were identified. Kaplan-Meier and multivariate Cox regression analysis was used to evaluate survival outcomes and prognostic factors.

Results: 1,960 patients (66.4%) had some extent of regional lymph node sampling, with 453 patients (15.3%) having ≥ 10 lymph nodes removed. Multivariate analysis demonstrated that tumor size ≥3cm and the number of positive lymph nodes had the strongest association with decreased survival (p<0.001). Advanced age, male sex and positive surgical margins also negatively impacted survival(p<0.001).

Conclusions: While ACC is considered a low-grade neoplasm with good overall prognosis, tumor size and lymph node involvement have a strong negative impact on outcomes.

Keywords: parotid gland, acinic cell carcinoma, survival, prognosis, treatment.