Prognostic factors and survival in patients with adenoid cystic carcinomas of the submandibular gland: a retrospective study of 38 cases from a single centre.

A retrospective review was performed to evaluate the prognostic factors and survival of patients with submandibular gland adenoid cystic carcinomas (ACCs), covering the period January 2006-December 2022. Thirty-eight patients were identified, 25 female and 13 male (age range 25-83 years, median 54.5 years). Surgical excision was performed in all patients, and the occult node metastasis rate was 17.1%. The median follow-up time was 61.5 months (range 13-169 months). Ten patients (26.3%) developed recurrent disease after initial surgery. Nine patients died during follow-up. The 5-year overall survival and disease-free survival rates were 81.1% and 75.4%, respectively. AJCC T-classification 3/4 (vs 1/2), AJCC TNM stage III/IV (vs I/II), positive surgical margin, presence of extra-glandular extension, and histological grade III (vs I/II) had a significant negative impact on both overall survival and disease-free survival. The findings of this study confirm the important impact of several clinicopathological factors on an unfavourable prognosis. Furthermore, radical surgery with tumour-free margins is recommended for patients with localized submandibular gland ACCs. Elective neck treatment is indicated for patients with advanced stage submandibular gland ACCs. Moreover, improvements in disease detection in the early stage and multicentre studies should be encouraged.