Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients - Université de Picardie Jules Verne Accéder directement au contenu
Article Dans Une Revue European Journal of Cancer Année : 2023

Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients

François Régis Ferrand
  • Fonction : Auteur
Sarah Atallah
  • Fonction : Auteur
Olivier Malard
Caroline Even
  • Fonction : Auteur
Erwan de Monès
  • Fonction : Auteur
Nazim Benzerdjeb
Diane Evrard
Vianney Bastit
Florent Espitalier
Marion Classe
  • Fonction : Auteur
Mélanie Doré
  • Fonction : Auteur
Stéphanie Wong
  • Fonction : Auteur
Charles Dupin
France Nguyen
  • Fonction : Auteur
Ariane Lapierre
  • Fonction : Auteur
Emilien Colin
Pierre Philouze
  • Fonction : Auteur
Sébastien Vergez
Bertrand Baujat
  • Fonction : Auteur
Philippe Herman
  • Fonction : Auteur
Benjamin Verillaud
  • Fonction : Auteur

Résumé

Background: Acinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The aim of this work was to analyse data from the national REFCOR multicenter cohort (i) to investigate the prognostic factors influencing survival outcomes in AciCC, (ii) to assess the impact on survival of postoperative radiotherapy (RT) in patients treated for AciCC without high-grade transformation and (iii) to explore the prognostic impact of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary glands. Patients and methods: Data from all the patients treated for salivary AciCC between 2009 and 2020 were extracted from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate analyses. Propensity score matching was used to assess the impact of postoperative RT and prophylactic ND on DFS. Results: A total of 187 patients were included. After a median follow-up of 53 months, their 5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis, male sex, older age, higher T and N status, and high grade were independently associated with a worse DFS. In the subpopulation analysed after propensity score matching, patients with cN0 AciCC without high-grade transformation who were treated by surgery and RT did not have an improved DFS compared to patients who were treated by surgery alone (hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3-T4 status and intermediate/high histological grade. After propensity score matching, prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16). Conclusions: These results suggest that (i) long-term follow-up (>5 years) should be considered in patients with AciCC, (ii) treatment by surgery alone could be an option in selected cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND may be considered preferentially in patients with T3-T4 status and/or intermediate/high histological grade.

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Florian Chatelet, François Régis Ferrand, Sarah Atallah, Juliette Thariat, François Mouawad, et al.. Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients. European Journal of Cancer, 2023, 185, pp.11-27. ⟨10.1016/j.ejca.2023.02.020⟩. ⟨hal-04044097⟩
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