A single center retrospective clinical study on head and neck adenoid cystic carcinoma

A single center retrospective clinical study on head and neck adenoid cystic carcinoma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A single center retrospective clinical study on head and neck adenoid cystic carcinoma Jinzi Liang, Alejandro Andree Alcas Villena, Wenjing Wang, Chao Wan, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6688245/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: The aim of this study was to investigate whether postoperative treatment (POT) like postoperative radiotherapy (PORT) and postoperative radiochemotherapy (PORCT) is beneficial for patients with adenoid cystic carcinoma (ACC) of the head and neck compared with surgery alone. Materials and methods: This retrospective study included 114 patients with adenoid cystic RESULTS: In the entire cohort, adjuvant therapy did not significantly improve progression-free survival (PFS) in patients with head and neck adenoid cystic carcinoma (HNACC) from January 2011 to August 2023, of whom 35 patients did not receive postoperative adjuvant therapy, 42 patients received PORT and 37patients received PORCT. Possible correlations between clinical parameters and outcomes were examined using Kaplan-Meier analysis and Cox proportional risk regression modeling. PFS in ACC of the head and neck, neither in early-stage patients nor in patients with locally advanced disease. In this study, we found that the stage of HNACC, nerve invasion, the extent of surgical resection, and the level of Ki-67 could be regarded as independent prognostic factors affecting the PFS of patients with HNACC, while whether the HNACC originates from the major salivary glands (parotid, submandibular, and sublingual) or the minor salivary glands did not have a significant effect on the PFS of patients. Among these risk factors, .Among patients with perineural invasion (PI), postoperative radiotherapy (PORT) provided a significant local failure-free survival (LFFS) benefit compared to surgery alone, whereas postoperative radiochemotherapy (PORCT) showed no additional advantage. Conclusion: For HNACC with perineural invasion, the benefit of PORT is higher than that of surgical resection alone and PORCT. HNACC Postoperative treatment Adjuvent chemotherapy Adjuvent radiotherapy Perineural invasion Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Salivary gland tumors are rare malignancies that account for less than 1% of all cancers and 3–6% of head and neck tumors, and are characterized by a wide range of histological subtypes and anatomical features[1, 2]. Adenoid cystic carcinoma is one of them, accounting for about 10% of all salivary gland tumors, and is the most common type of cancer histology of the minor salivary glands (MSGs), as well as one of the most common cancers of the major salivary glands (parotid, submandibular, and sublingual) [3, 4]. In addition to the salivary glands, adenoid cystic carcinoma may originate from the lacrimal gland, nasal cavity, larynx, pharynx, and other parts of the head and neck [5, 6]. Although several studies have shown that patients with adenoid cystic carcinoma usually have a long survival due to its slow growth pattern, local recurrence and distant metastasis still pose many challenges in its treatment, and may even be “incurable”[4, 7, 8]. The main treatment for HNACC is radical surgical resection [9–11]. However, achieving clear margins in advanced HNACC remains challenging through surgery due to the nature of its nerve-invasive growth [12–14]. PORT is often recommended for such patients with risk factors (T3/T4, R1/R2 resection), and several retrospective studies have shown that PORT prolongs survival in patients with high risk factors [15, 16]. However, due to the lack of high-level clinical trial evidence, the role of postoperative adjuvant therapy in HNACC is not definitive. In order to clarify the benefit of postoperative adjuvant therapy in HNACC, a total of 114 cases treated in our hospital from January 2011 to August 2023 were collected and analyzed retrospectively in this study. To explore the influence of relevant risk factors in the choice of adjuvant therapy for HNACC. Material and Method 4.1 Patient population This study was conducted in accordance with the ethical guidelines of the Declaration of Helsinki of the World Medical Association. Approval was obtained from the Ethics Committee of Wuhan Union Hospital. Informed consent was obtained in accordance with legal requirements. A total of 188 patients with HNACC treated at the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 1, 2011 to August 31, 2023 were included in this study, all of whom were confirmed as HNACC by the Department of Pathology of the Wuhan Union Hospital, and the staging as well as the criteria for the surgical margins were evaluated in accordance with the eighth edition of the American Joint Committee on Cancer[17]. In this study, 15 patients with distant metastases at the initial diagnosis, 45 patients with severely incomplete imaging data, and 17 patients who refused follow-up treatment were excluded. Of the remaining 114 patients, 49 were male and 65 were female, and their ages at diagnosis ranged from 12 to 78 years old(Fig. 1 ). 4.2 Patient treatment All 114 patients underwent resection. All patients were divided into 3 groups according to the POT: Surgery only (SO), PORT and POCRT. For patients receiving PORT, image-guided intensity-modulated radiotherapy (IMRT) was administered for radiation therapy. For gross tumor volume (GTV), the radiotherapy dose was 66–72 Gy, and 60–66 Gy for the tumor bed, 54–60 Gy for prophylaxis. The patients received 5 radiation treatments per week at a fraction of 1.8-2 Gy. For concurrent radiochemotherapy, the cisplatin chemotherapy is given at a dose of 100 mg/m 2 every 3 weeks or 40 mg/m 2 weekly. Patients receiving postoperative chemotherapy completed ≥ 2 cycles of platinum-containing drugs with a cisplatin dose of 75 mg/m 2 [18, 19]. 4.3 Statistics PFS is calculated from the date of initiation of treatment until the patient's disease progression or death, and LFFS (local failure-free survival) is calculated from the date of initiation of treatment until the progression of local disease. Survival status was estimated using the Kaplan-Meier (KM) curve. We chose PFS as the primary study endpoint because, as a slower-growing tumor, only a fraction of patients achieved LFFS results. To find independent risk factors associated with disease recurrence or progression, we used a one-way COX regression analysis. We used SPSS version 27 (IBM, Armonk, New York) for analysis. Two-tailed P values < 0.05 was considered statistically significant. Results 5.1 Patient characteristics Table 1 shows the baseline characteristics of the overall cohort. A total of 114 patients without distant metastases were enrolled in this study. The median age at initial treatment was 55 years. Thirty-eight patients with primary foci located in the major salivary glands accounted for 29.9% of all patients, and the remaining 70.1% had primary foci located in the minor salivary glands. All patients underwent surgical resection, with 65 patients (51.2%) achieving R0 resection, 25 patients (19.7%) achieving R1 resection, and 25 patients (19.7%) having R2 resection; all R2 patients had postoperative residuals detected by CT, MR, or PET/CT. The extent of resection was unclear in another 12 patients (9.4%) because they did not undergo postoperative MR or CT at our institution. From the pathologic specimens, it was known that there were 45 patients (35.4%) with perineural invasion(PI) and 82 patients (64.6%) without nerve invasion. Of all the patients, 35 (27.6%) received surgery only, and 92 (72.4%) were treated with postoperative adjuvant therapy, including 42 (33.1%) with postoperative adjuvant radiotherapy, 37 (29.1%) with postoperative radiochemotherapy, and 13 (10.2%) with postoperative adjuvant chemotherapy. Overall, the use of postoperative adjuvant therapy, especially chemotherapy, was preferred in patients with cervical lymph node metastases. Table 1 Patient characteristics Characteristic Treatment Surgery Entire Cohort PORT POCRT Number of patients (%) 35(27.6%) 42(33.1%) 37(29.1%) P 114 Age Median, year 55 53 50 0.121 53 =65years 7 7 1 15 Sex Male 11 17 22 0.178 50 Female 24 25 15 64 Tumor subsite Minor salivary gland 25 27 30 0.826 83 Major salivary gland 10 15 9 34 T stage T1 5 6 5 0.199 16 T2 13 15 7 36 T3 6 10 9 31 T4 11 11 16 44 N stage N1 3 0 5 0.002 12 N2 3 0 4 7 N3 0 0 0 1 TNM stage I 4 8 6 0.126 18 II 12 12 4 29 III 8 11 10 33 IV 13 11 15 47 Resection type R0 (1 mm) 20 25 16 0.121 65 R1 (< 1 mm) 8 7 9 25 R2 3 7 8 25 NA 4 3 2 12 Perineual invasion Yes 13 15 13 0.982 45 No 22 27 26 82 5.2 Treatment outcomes In the entire cohort, patients were followed for a median of 42 months, with 87 patients (68.5%) without tumor recurrence or progression and 98 patients (77.1%) without local recurrence by the end of the study. There was no significant difference in PFS (P = 0.022) and LFFS (P = 0.663) in patients with R0 resection compared to patients with R1/R2 resection. Importantly, patients without PI had a better PFS rate (P = 0.041) compared to patients with PI, while there was no significant difference in LFFS (P = 0.307). In the entire cohort, adjuvant therapy did not demonstrate a significant PFS benefit compared to surgery alone (P = 0.194), but significantly improved patient LFFS (P = 0.034) in the entire cohort(Fig. 2 .AB). No significant PFS (P = 0.50) or LFFS (P = 0.121) benefit was seen with adjuvant therapy in patients with early-stage HNACC(Fig. 2 .CD), and in patients with locally advanced HNACC, patients receiving adjuvant therapy had a higher median PFS (98months vs. 46months, P = 0.199) and median LFFS (98m vs. 75m, P = 0.107) than patients undergoing surgery alone, although there wasn’t statistically significant difference between them(Fig. 2 .EF). Among patients who did not achieve a safe margin during surgery, PFS (P = 0.958) and LFFS (P = 0.963) did not show significant differences between patients who received adjuvant therapy and those who underwent surgery alone(Fig. 3 .). To further explore which populations benefit from adjuvant therapy, we performed subgroup analyses based on risk factors. Importantly, among patients with PI, those who received adjuvant therapy had a significantly higher median PFS than those who had surgery alone (64m vs. 25m, P = 0.021)(Fig. 4 .). Additionally in patients with PI, patients with the addition of adjuvant therapy did not achieve a median LFFS that was significantly higher than patients with surgery alone (46m, P = 0.015). To further explore which type of adjuvant therapy benefits patients more, we performed a subgroup analysis depending on the type of adjuvant therapy imposed. We found that patients who received postoperative radiotherapy had a significantly higher median PFS than those who had surgery alone (64m vs. 25m, P = 0.046). Among PI-positive patients, adjuvant therapy was associated with significantly improved PFS (P = 0.021) and LFFS (P = 0.015) than those who did not receive adjuvant therapy, and among this group of patients postoperative radiotherapy (PORCT) patients did not see a significant PFS (P = 0.309) boost compared to patients with surgery alone, while there was a trend toward a higher LFFS (P = 0.061)(Fig. 5 .AB). Postoperative radiotherapy (PORT) showed a significant PFS boost (P = 0.046) and a trend toward an improved LFFS (P = 0.105) over surgery alone(Fig. 5 .CD). 5.3 Univariate analyses of factors associated with PFS and LFFS The results of the univariate analysis of all patients are presented in Table 2. Among them, patients’ age and gender of the disease had no significant correlation with the improvement of patients' PFS and LFFS. Patients with clinical stage III-IV had worse PFS than those with stage I-II (P < 0.001,HR = 1.413,95% CI). Those with nodal metastasis have a worse PFS (P = 0.024,HR = 0.34,95% CI). Notably, perinueral invasion of the tumor was significantly associated with worse PFS (P = 0.034, HR = 2.179,95%CI). Table 2. Univariate analyses of factors associated with PFS and LFFS Discussion Surgery remains the cornerstone of radical treatment for HNACC [20, 21]. Yet achieving clear margins in advanced cases remains a persistent challenge due to the tumor’s proclivity for perineural invasion (PI) and insidious growth patterns [12, 22]. While postoperative therapy (POT) is widely advocated for high-risk patients[23, 24], its role in HNACC has been inconsistently reported across studies. Our findings demonstrate that adjuvant therapy did not confer a significant PFS benefit in the overall cohort, aligning with prior reports suggesting that HNACC’s indolent nature complicates the evaluation of therapeutic efficacy. Other studies, however, reported that OS and PFS are both improved in patients with POT [15, 22]. It still requires exploration about the group of people in need of POT and which kind of POT is most suitable for them. In the present study, we did not find the POT having significant influence on PFS or LFFS of the whole cohort. But in the subgroup analysis, we discovered that in specific group, such as patients with PI, PFS and LFFS improvement was observed, while POCRT didn’t gain significant benefit. In multiple study, PI is considered as a high risk factor for poor prognosis [25, 26]. One study has shown that patients with parotid gland cancer and facial weakness had poor clinical outcomes (44.0%, 3-year PFS) [20]. PI is strongly associated with factors including surgical margin status, tumor location, and histopathological grade. During these factors, margin status is considered one of the most significantly correlated. When the surgical margin is positive, PI may show presence in 88% of patients with HNACC [27]. The selective benefit of PORT in PI-positive patients may stem from its ability to target microscopic tumor extensions along neural pathways. Adenoid cystic carcinoma (ACC) is notorious for its “skip lesions,” where tumor cells infiltrate nerves discontinuously, evading surgical resection [28]. In this study, PORT significantly improved PFS and LFFS in PI-positive patients, potentially by disrupting perineural tumor spread pathways, and the “skip channel” is severed, thereby improving the LFFS. In addition, patients with PI have a shorter PFS and OS, and the survival benefit of increased local radiotherapy is more observable. Our results advocate for risk-adapted adjuvant therapy. For PI-positive patients, PORT should be prioritized, as it conferred a median PFS advantage of 39 months over surgery alone. However, the absence of benefit in R1/R2 resection subgroups suggests that margin status alone may not suffice for adjuvant decision-making. Owing to the indolent progressing course, HNACC is not sensitive to chemotherapy, and has a long PFS and OS time, making it difficult to assess the influence of adjuvant therapy [29–31]. Therefore, whether adding chemotherapy to PORT (POCRT) can further improve efficacy remains controversial[19, 22]. A review concluding 114 studies suggests that chemotherapy is ineffective to most HNACC, with a short duration of objective responses of merely months[30]. Furthermore, the lack of benefit from PORCT suggests that chemotherapy agents like cisplatin may have limited penetration into the perineural niche or insufficient activity against ACC’s slow-cycling tumor cells. This underscores the need for mechanistic studies to identify molecular targets within neural-invasive niches, such as the CXCR4/SDF-1 axis, which has been implicated in ACC progression. However, some studies still show significance in chemotherapy. A study concluding 174 HNACC patients reports that while no significant improvements in OS or DFS, patients receiving POCRT show better LCR and opioid-requiring pain-free survival than PORT, especially in patients with late clinical stage, positive surgical margins, and PI [18]. In the present study, POCRT also shows a tendency to benefit in patients with PI. However, The benefit of POCRT in these populations still needs to be confirmed by prospective RCTs. Except for adjuvant therapy, neoadjuvant therapy may become a solution to HNACC therapy. It is currently unclear whether neoadjuvant radiotherapy or neoadjuvant radiotherapy combined with chemotherapy provides benefits for patients with HNACC. Moreover, in the era of immunotherapy, neoadjuvant treatment based on immunotherapy is also worth exploring. Although the role of neoadjuvant therapy with chemotherapy combined with immunotherapy on the increase of survival benefit in head and neck squamous carcinoma has been supported by some clinical studies [32, 33], including the single-arm phase II clinical study of our group to be sent out in 2022 [34], the role of neoadjuvant therapy in HNACC remains to be explored. Neoadjuvant therapy may help HNACC achieve a better R0 resection rate in surgical resection as a way to improve patient prognosis. However, there are no prospective clinical studies on neoadjuvant therapy for HNACC, and its efficacy needs to be further explored. While our study provides actionable insights, its retrospective design and single-center cohort limit generalizability. Heterogeneity in radiotherapy techniques (e.g., variable prophylactic dosing) and the small sample size for PORCT subgroups (n = 37) may have obscured treatment effects. Furthermore, the median follow-up of 42 months is insufficient for a tumor with a 10-year recurrence risk. Prospective multi-institutional trials with extended follow-up are imperative to validate our findings. Such studies should also incorporate next-generation sequencing to identify molecular subtypes responsive to specific therapies, as ACC’s heterogeneity demands personalized approaches. Summary In summary, the current retrospective study showed that perineural invasion, failure to achieve safe margins and advanced clinical staging predicted poorer PFS and LFFS. For patients with adenoid cystic carcinoma with PI, postoperative adjuvant therapy significantly improved their PFS and LFFS rates compared to surgery alone, and when it came to the type of postoperative adjuvant therapy to be adopted, postoperative adjuvant radiotherapy significantly improved the prognosis of patients with PI. This study refines the role of adjuvant therapy in HNACC, emphasizing PORT’s value in PI-positive patients. By elucidating the interplay between tumor biology and treatment modality, our findings pave the way for biologically informed, risk-stratified management paradigms. Future efforts must prioritize translational research to bridge the gap between mechanistic understanding and clinical application in this enigmatic malignancy. Declarations Acknowledgements We thank all members of the group at the cancer center,Wuhan Union Hospital for their kindness and help. The study was approved by the Institutional Ethics Committee of Wuhan Union Hospital. Formal consent was waived because of the retrospective nature of this study. All individual-level data were anonymized and only available to authorized researchers. Authors’ contributions All authors contributed to the conception and drafting of the manuscript and have read and approved the final manuscript. Funding This research didn’t receive any any form of sponsorship. Clinical trial number Not applicable. Competing interests The author declares that he has no competing interests. Ethics approval and consent to participate This research is approved by Ethics Committee of Wuhan Union Hospital. References Bjørndal, K., et al., Salivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol, 2011. 47 (7): p. 677-82. Chummun, S., et al., Adenoid cystic carcinoma of the head and neck. Br J Plast Surg, 2001. 54 (6): p. 476-80. Coca-Pelaz, A., et al., Adenoid cystic carcinoma of the head and neck--An update. Oral Oncol, 2015. 51 (7): p. 652-61. Del Signore, A.G. and U.C. Megwalu, The rising incidence of major salivary gland cancer in the United States. Ear Nose Throat J, 2017. 96 (3): p. E13-e16. Argyris, P.P., et al., Lacrimal gland adenoid cystic carcinoma with high-grade transformation to myoepithelial carcinoma: report of a case and review of literature. Head Neck Pathol, 2013. 7 (1): p. 85-92. Cantù, G., Adenoid cystic carcinoma. An indolent but aggressive tumour. Part A: from aetiopathogenesis to diagnosis. Acta Otorhinolaryngol Ital, 2021. 41 (3): p. 206-214. Ciccolallo, L., et al., Survival from salivary glands adenoid cystic carcinoma in European populations. Oral Oncol, 2009. 45 (8): p. 669-74. DeAngelis, A.F., et al., Outcomes of patients with adenoid cystic carcinoma of the minor salivary glands. Int J Oral Maxillofac Surg, 2011. 40 (7): p. 710-4. Cantù, G., Adenoid cystic carcinoma. An indolent but aggressive tumour. Part B: treatment and prognosis. Acta Otorhinolaryngol Ital, 2021. 41 (4): p. 296-307. Mendenhall, W.M., et al., Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck. Head Neck, 2004. 26 (2): p. 154-62. Casler, J.D. and J.J. Conley, Surgical management of adenoid cystic carcinoma in the parotid gland. Otolaryngol Head Neck Surg, 1992. 106 (4): p. 332-8. Garden, A.S., et al., The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation. Int J Radiat Oncol Biol Phys, 1995. 32 (3): p. 619-26. Erovic, B.M., et al., Outcome analysis of 215 patients with parotid gland tumors: a retrospective cohort analysis. J Otolaryngol Head Neck Surg, 2015. 44 : p. 43. Lee, S.Y., B.H. Kim, and E.C. Choi, Nineteen-year oncologic outcomes and the benefit of elective neck dissection in salivary gland adenoid cystic carcinoma. Head Neck, 2014. 36 (12): p. 1796-801. Hsieh, R.C., et al., A multicenter retrospective analysis of patients with salivary gland carcinoma treated with postoperative radiotherapy alone or chemoradiotherapy. Radiother Oncol, 2023. 188 : p. 109891. Cerda, T., et al., A rationale for chemoradiation (vs radiotherapy) in salivary gland cancers? On behalf of the REFCOR (French rare head and neck cancer network). Crit Rev Oncol Hematol, 2014. 91 (2): p. 142-58. Edition, S., S. Edge, and D. Byrd, AJCC cancer staging manual. AJCC cancer staging manual, 2017. Hsieh, C.E., et al., Adding concurrent chemotherapy to postoperative radiotherapy improves locoregional control but Not overall survival in patients with salivary gland adenoid cystic carcinoma-a propensity score matched study. Radiat Oncol, 2016. 11 : p. 47. Tsan, D.L., et al., The comparison between weekly and three-weekly cisplatin delivered concurrently with radiotherapy for patients with postoperative high-risk squamous cell carcinoma of the oral cavity. Radiat Oncol, 2012. 7 : p. 215. Park, W., et al., Clinical outcomes and management of facial nerve in patients with parotid gland cancer and pretreatment facial weakness. Oral Oncol, 2019. 89 : p. 144-149. Zbären, P., et al., Elective neck dissection versus observation in primary parotid carcinoma. Otolaryngol Head Neck Surg, 2005. 132 (3): p. 387-91. Michel, G., et al., Adenoid cystic carcinoma of the paranasal sinuses: retrospective series and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis, 2013. 130 (5): p. 257-62. Min, R., et al., Salivary gland adenoid cystic carcinoma with cervical lymph node metastasis: a preliminary study of 62 cases. Int J Oral Maxillofac Surg, 2012. 41 (8): p. 952-7. Renehan, A.G., et al., Clinico-pathological and treatment-related factors influencing survival in parotid cancer. Br J Cancer, 1999. 80 (8): p. 1296-300. Carlson, M.L., et al., Occult Temporal Bone Facial Nerve Involvement by Parotid Malignancies with Perineural Spread. Otolaryngol Head Neck Surg, 2015. 153 (3): p. 385-91. Gandolfi, M.M. and W. Slattery, 3rd, Parotid Gland Tumors and the Facial Nerve. Otolaryngol Clin North Am, 2016. 49 (2): p. 425-34. Barrett, A.W. and P.M. Speight, Perineural invasion in adenoid cystic carcinoma of the salivary glands: a valid prognostic indicator? Oral Oncol, 2009. 45 (11): p. 936-40. Khan, A.J., et al., Adenoid cystic carcinoma: a retrospective clinical review. Int J Cancer, 2001. 96 (3): p. 149-58. Andry, G., et al., Management of salivary gland tumors. Expert Rev Anticancer Ther, 2012. 12 (9): p. 1161-8. Dodd, R.L. and N.J. Slevin, Salivary gland adenoid cystic carcinoma: a review of chemotherapy and molecular therapies. Oral Oncol, 2006. 42 (8): p. 759-69. Ghosal, N., et al., Phase II study of cisplatin and imatinib in advanced salivary adenoid cystic carcinoma. Br J Oral Maxillofac Surg, 2011. 49 (7): p. 510-5. Vos, J.L., et al., Neoadjuvant immunotherapy with nivolumab and ipilimumab induces major pathological responses in patients with head and neck squamous cell carcinoma. Nat Commun, 2021. 12 (1): p. 7348. Ferrarotto, R., et al., Pilot Phase II Trial of Neoadjuvant Immunotherapy in Locoregionally Advanced, Resectable Cutaneous Squamous Cell Carcinoma of the Head and Neck. Clin Cancer Res, 2021. 27 (16): p. 4557-4565. Zhang, Z., et al., Neoadjuvant Chemoimmunotherapy for the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: A Single-Arm Phase 2 Clinical Trial. Clin Cancer Res, 2022. 28 (15): p. 3268-3276. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6688245","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":461436276,"identity":"fd388ad6-e8e4-4dc9-b2c1-1c086f288683","order_by":0,"name":"Jinzi Liang","email":"","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jinzi","middleName":"","lastName":"Liang","suffix":""},{"id":461436277,"identity":"ddb1f5f5-4531-4f8d-ade3-40af85c220cb","order_by":1,"name":"Alejandro Andree Alcas Villena","email":"","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Alejandro","middleName":"Andree Alcas","lastName":"Villena","suffix":""},{"id":461436278,"identity":"1e8740ad-c43c-4e5e-8ae5-14fa002dac1f","order_by":2,"name":"Wenjing Wang","email":"","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Wenjing","middleName":"","lastName":"Wang","suffix":""},{"id":461436279,"identity":"1df7c0cd-25a0-4b78-8e1d-d29a621feb6e","order_by":3,"name":"Chao Wan","email":"","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chao","middleName":"","lastName":"Wan","suffix":""},{"id":461436280,"identity":"466f2c0f-9ae9-4e68-b909-4382e20ec558","order_by":4,"name":"Shuhan Zhao","email":"","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shuhan","middleName":"","lastName":"Zhao","suffix":""},{"id":461436281,"identity":"b9a5a534-1ae4-4a37-84ce-49852f9bd737","order_by":5,"name":"xixi liu","email":"","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"xixi","middleName":"","lastName":"liu","suffix":""},{"id":461436282,"identity":"1121c7b8-bd0d-4f7e-8485-d15b0ee47578","order_by":6,"name":"Lu Wen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYHACxgMMFTY8/OyNjQ8+EKvnAMOZNDnJnsPNhjOI1sLYdtjY4EZ6mzQHMcoNjvceOMzDlpY4c+bDBmkGBjs53QZCWs6cSzjMw2OT2C+d2GBcwJBsbHaAgBazGzkGh3kkgLbMTmxInsFwIHEbQS333wC1GBxO3HDzYMNhHqK03ACq50kAeZ+xsZkoLfZncgwOzjkACuTEZsYZBkT4RbL9jOGDt/9AUXn8+Y8PFXZyBLWgAQPSlI+CUTAKRsEowAEADf9KlFBEdYkAAAAASUVORK5CYII=","orcid":"","institution":"Wuhan Union Hospital","correspondingAuthor":true,"prefix":"","firstName":"Lu","middleName":"","lastName":"Wen","suffix":""}],"badges":[],"createdAt":"2025-05-17 16:53:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6688245/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6688245/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83544236,"identity":"8ca4bea9-48c1-4151-ae6c-3aac185285bd","added_by":"auto","created_at":"2025-05-28 08:47:52","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":45462,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of screening and groups of patients\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6688245/v1/99c6d83452c75d7d8fe4d08b.jpg"},{"id":83543779,"identity":"4e2aaf39-1e90-40d7-aadb-dcb20a7e4e29","added_by":"auto","created_at":"2025-05-28 08:39:52","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":206588,"visible":true,"origin":"","legend":"\u003cp\u003eProgression-free survival and Local-failure-free curves in patients receiving adjuvant therapy or not.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6688245/v1/c180a08d62f027ef95984816.jpg"},{"id":83544235,"identity":"c2003f19-4629-48ee-8f8d-fc0ca503f227","added_by":"auto","created_at":"2025-05-28 08:47:52","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":52401,"visible":true,"origin":"","legend":"\u003cp\u003eProgression-free survival and Local-failure-free curves in patients with R0 resection vs. R1/R2 resection\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6688245/v1/a794920b4aa4ce9b0da5d9a1.jpg"},{"id":83543780,"identity":"846b00c7-a872-4572-8f94-08d5d3fdfbc4","added_by":"auto","created_at":"2025-05-28 08:39:52","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":56226,"visible":true,"origin":"","legend":"\u003cp\u003eProgression-free survival and Local-failure-free curves in patients with peineural invision or not.\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6688245/v1/7710e25c0905684ef7ea2b1a.jpg"},{"id":83544237,"identity":"d27b0f89-2f77-4b3b-b71c-1b868cb25af1","added_by":"auto","created_at":"2025-05-28 08:47:52","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":56831,"visible":true,"origin":"","legend":"\u003cp\u003eProgression-free survival and Local-failure-free curves in patients with Perineural invision recevingPOCRT,PORT,POCT or surgery only\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6688245/v1/8bb5140ec0c6270bd0ee3cd9.jpg"},{"id":84669018,"identity":"befd24d5-157b-4285-ad14-5d4fbc00828a","added_by":"auto","created_at":"2025-06-16 06:23:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1015501,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6688245/v1/7228c814-1c91-44c3-a0ab-8b7a5846c27b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A single center retrospective clinical study on head and neck adenoid cystic carcinoma","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSalivary gland tumors are rare malignancies that account for less than 1% of all cancers and 3–6% of head and neck tumors, and are characterized by a wide range of histological subtypes and anatomical features[1, 2]. Adenoid cystic carcinoma is one of them, accounting for about 10% of all salivary gland tumors, and is the most common type of cancer histology of the minor salivary glands (MSGs), as well as one of the most common cancers of the major salivary glands (parotid, submandibular, and sublingual) [3, 4]. In addition to the salivary glands, adenoid cystic carcinoma may originate from the lacrimal gland, nasal cavity, larynx, pharynx, and other parts of the head and neck [5, 6]. Although several studies have shown that patients with adenoid cystic carcinoma usually have a long survival due to its slow growth pattern, local recurrence and distant metastasis still pose many challenges in its treatment, and may even be “incurable”[4, 7, 8].\u003c/p\u003e \u003cp\u003eThe main treatment for HNACC is radical surgical resection [9–11]. However, achieving clear margins in advanced HNACC remains challenging through surgery due to the nature of its nerve-invasive growth [12–14]. PORT is often recommended for such patients with risk factors (T3/T4, R1/R2 resection), and several retrospective studies have shown that PORT prolongs survival in patients with high risk factors [15, 16]. However, due to the lack of high-level clinical trial evidence, the role of postoperative adjuvant therapy in HNACC is not definitive. In order to clarify the benefit of postoperative adjuvant therapy in HNACC, a total of 114 cases treated in our hospital from January 2011 to August 2023 were collected and analyzed retrospectively in this study. To explore the influence of relevant risk factors in the choice of adjuvant therapy for HNACC.\u003c/p\u003e"},{"header":"Material and Method","content":"\u003cp\u003e4.1 Patient population\u003c/p\u003e\u003cp\u003e This study was conducted in accordance with the ethical guidelines of the Declaration of Helsinki of the World Medical Association. Approval was obtained from the Ethics Committee of Wuhan Union Hospital. Informed consent was obtained in accordance with legal requirements. A total of 188 patients with HNACC treated at the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 1, 2011 to August 31, 2023 were included in this study, all of whom were confirmed as HNACC by the Department of Pathology of the Wuhan Union Hospital, and the staging as well as the criteria for the surgical margins were evaluated in accordance with the eighth edition of the American Joint Committee on Cancer[17]. In this study, 15 patients with distant metastases at the initial diagnosis, 45 patients with severely incomplete imaging data, and 17 patients who refused follow-up treatment were excluded. Of the remaining 114 patients, 49 were male and 65 were female, and their ages at diagnosis ranged from 12 to 78 years old(Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e4.2 Patient treatment\u003c/p\u003e\u003cp\u003eAll 114 patients underwent resection. All patients were divided into 3 groups according to the POT: Surgery only (SO), PORT and POCRT. For patients receiving PORT, image-guided intensity-modulated radiotherapy (IMRT) was administered for radiation therapy. For gross tumor volume (GTV), the radiotherapy dose was 66–72 Gy, and 60–66 Gy for the tumor bed, 54–60 Gy for prophylaxis. The patients received 5 radiation treatments per week at a fraction of 1.8-2 Gy. For concurrent radiochemotherapy, the cisplatin chemotherapy is given at a dose of 100 mg/m\u003csup\u003e2\u003c/sup\u003e every 3 weeks or 40 mg/m\u003csup\u003e2\u003c/sup\u003e weekly. Patients receiving postoperative chemotherapy completed ≥ 2 cycles of platinum-containing drugs with a cisplatin dose of 75 mg/m\u003csup\u003e2\u003c/sup\u003e [18, 19].\u003c/p\u003e\u003cp\u003e4.3 Statistics\u003c/p\u003e\u003cp\u003ePFS is calculated from the date of initiation of treatment until the patient's disease progression or death, and LFFS (local failure-free survival) is calculated from the date of initiation of treatment until the progression of local disease. Survival status was estimated using the Kaplan-Meier (KM) curve. We chose PFS as the primary study endpoint because, as a slower-growing tumor, only a fraction of patients achieved LFFS results. To find independent risk factors associated with disease recurrence or progression, we used a one-way COX regression analysis. We used SPSS version 27 (IBM, Armonk, New York) for analysis. Two-tailed P values \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e5.1 Patient characteristics\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the baseline characteristics of the overall cohort. A total of 114 patients without distant metastases were enrolled in this study. The median age at initial treatment was 55 years. Thirty-eight patients with primary foci located in the major salivary glands accounted for 29.9% of all patients, and the remaining 70.1% had primary foci located in the minor salivary glands. All patients underwent surgical resection, with 65 patients (51.2%) achieving R0 resection, 25 patients (19.7%) achieving R1 resection, and 25 patients (19.7%) having R2 resection; all R2 patients had postoperative residuals detected by CT, MR, or PET/CT. The extent of resection was unclear in another 12 patients (9.4%) because they did not undergo postoperative MR or CT at our institution. From the pathologic specimens, it was known that there were 45 patients (35.4%) with perineural invasion(PI) and 82 patients (64.6%) without nerve invasion. Of all the patients, 35 (27.6%) received surgery only, and 92 (72.4%) were treated with postoperative adjuvant therapy, including 42 (33.1%) with postoperative adjuvant radiotherapy, 37 (29.1%) with postoperative radiochemotherapy, and 13 (10.2%) with postoperative adjuvant chemotherapy. Overall, the use of postoperative adjuvant therapy, especially chemotherapy, was preferred in patients with cervical lymph node metastases.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatment\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eEntire Cohort\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePORT\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePOCRT\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of patients (%)\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e35(27.6%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e42(33.1%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e37(29.1%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian, year\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt; 65years\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=65years\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.178\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eTumor subsite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinor salivary gland\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.826\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMajor salivary gland\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eT stage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eT2\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eT3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eT4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eN stage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN1\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN2\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eTNM stage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.126\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eII\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIII\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIV\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eResection type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eR0 (1 mm)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eR1 (\u0026lt; 1 mm)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eR2\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ePerineual invasion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.982\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e5.2 Treatment outcomes\u003c/p\u003e\u003cp\u003eIn the entire cohort, patients were followed for a median of 42 months, with 87 patients (68.5%) without tumor recurrence or progression and 98 patients (77.1%) without local recurrence by the end of the study. There was no significant difference in PFS (P = 0.022) and LFFS (P = 0.663) in patients with R0 resection compared to patients with R1/R2 resection. Importantly, patients without PI had a better PFS rate (P = 0.041) compared to patients with PI, while there was no significant difference in LFFS (P = 0.307).\u003c/p\u003e\u003cp\u003eIn the entire cohort, adjuvant therapy did not demonstrate a significant PFS benefit compared to surgery alone (P = 0.194), but significantly improved patient LFFS (P = 0.034) in the entire cohort(Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.AB). No significant PFS (P = 0.50) or LFFS (P = 0.121) benefit was seen with adjuvant therapy in patients with early-stage HNACC(Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.CD), and in patients with locally advanced HNACC, patients receiving adjuvant therapy had a higher median PFS (98months vs. 46months, P = 0.199) and median LFFS (98m vs. 75m, P = 0.107) than patients undergoing surgery alone, although there wasn’t statistically significant difference between them(Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.EF). Among patients who did not achieve a safe margin during surgery, PFS (P = 0.958) and LFFS (P = 0.963) did not show significant differences between patients who received adjuvant therapy and those who underwent surgery alone(Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.). To further explore which populations benefit from adjuvant therapy, we performed subgroup analyses based on risk factors. Importantly, among patients with PI, those who received adjuvant therapy had a significantly higher median PFS than those who had surgery alone (64m vs. 25m, P = 0.021)(Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.). Additionally in patients with PI, patients with the addition of adjuvant therapy did not achieve a median LFFS that was significantly higher than patients with surgery alone (46m, P = 0.015). To further explore which type of adjuvant therapy benefits patients more, we performed a subgroup analysis depending on the type of adjuvant therapy imposed. We found that patients who received postoperative radiotherapy had a significantly higher median PFS than those who had surgery alone (64m vs. 25m, P = 0.046).\u003c/p\u003e\u003cp\u003eAmong PI-positive patients, adjuvant therapy was associated with significantly improved PFS (P = 0.021) and LFFS (P = 0.015) than those who did not receive adjuvant therapy, and among this group of patients postoperative radiotherapy (PORCT) patients did not see a significant PFS (P = 0.309) boost compared to patients with surgery alone, while there was a trend toward a higher LFFS (P = 0.061)(Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.AB). Postoperative radiotherapy (PORT) showed a significant PFS boost (P = 0.046) and a trend toward an improved LFFS (P = 0.105) over surgery alone(Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.CD).\u003c/p\u003e\u003cp\u003e5.3 Univariate analyses of factors associated with PFS and LFFS\u003c/p\u003e\u003cp\u003eThe results of the univariate analysis of all patients are presented in Table\u0026nbsp;2. Among them, patients’ age and gender of the disease had no significant correlation with the improvement of patients' PFS and LFFS. Patients with clinical stage III-IV had worse PFS than those with stage I-II (P \u0026lt; 0.001,HR = 1.413,95% CI). Those with nodal metastasis have a worse PFS (P = 0.024,HR = 0.34,95% CI). Notably, perinueral invasion of the tumor was significantly associated with worse PFS (P = 0.034, HR = 2.179,95%CI).\u003c/p\u003e\u003cp\u003eTable 2. Univariate analyses of factors associated with PFS and LFFS\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\" width=\"590\" height=\"224\"\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eSurgery remains the cornerstone of radical treatment for HNACC [20, 21]. Yet achieving clear margins in advanced cases remains a persistent challenge due to the tumor’s proclivity for perineural invasion (PI) and insidious growth patterns [12, 22].\u003c/p\u003e \u003cp\u003eWhile postoperative therapy (POT) is widely advocated for high-risk patients[23, 24], its role in HNACC has been inconsistently reported across studies. Our findings demonstrate that adjuvant therapy did not confer a significant PFS benefit in the overall cohort, aligning with prior reports suggesting that HNACC’s indolent nature complicates the evaluation of therapeutic efficacy. Other studies, however, reported that OS and PFS are both improved in patients with POT [15, 22]. It still requires exploration about the group of people in need of POT and which kind of POT is most suitable for them. In the present study, we did not find the POT having significant influence on PFS or LFFS of the whole cohort. But in the subgroup analysis, we discovered that in specific group, such as patients with PI, PFS and LFFS improvement was observed, while POCRT didn’t gain significant benefit.\u003c/p\u003e \u003cp\u003eIn multiple study, PI is considered as a high risk factor for poor prognosis [25, 26]. One study has shown that patients with parotid gland cancer and facial weakness had poor clinical outcomes (44.0%, 3-year PFS) [20]. PI is strongly associated with factors including surgical margin status, tumor location, and histopathological grade. During these factors, margin status is considered one of the most significantly correlated. When the surgical margin is positive, PI may show presence in 88% of patients with HNACC [27]. The selective benefit of PORT in PI-positive patients may stem from its ability to target microscopic tumor extensions along neural pathways. Adenoid cystic carcinoma (ACC) is notorious for its “skip lesions,” where tumor cells infiltrate nerves discontinuously, evading surgical resection [28]. In this study, PORT significantly improved PFS and LFFS in PI-positive patients, potentially by disrupting perineural tumor spread pathways, and the “skip channel” is severed, thereby improving the LFFS. In addition, patients with PI have a shorter PFS and OS, and the survival benefit of increased local radiotherapy is more observable. Our results advocate for risk-adapted adjuvant therapy. For PI-positive patients, PORT should be prioritized, as it conferred a median PFS advantage of 39 months over surgery alone. However, the absence of benefit in R1/R2 resection subgroups suggests that margin status alone may not suffice for adjuvant decision-making.\u003c/p\u003e \u003cp\u003eOwing to the indolent progressing course, HNACC is not sensitive to chemotherapy, and has a long PFS and OS time, making it difficult to assess the influence of adjuvant therapy [29–31]. Therefore, whether adding chemotherapy to PORT (POCRT) can further improve efficacy remains controversial[19, 22]. A review concluding 114 studies suggests that chemotherapy is ineffective to most HNACC, with a short duration of objective responses of merely months[30]. Furthermore, the lack of benefit from PORCT suggests that chemotherapy agents like cisplatin may have limited penetration into the perineural niche or insufficient activity against ACC’s slow-cycling tumor cells. This underscores the need for mechanistic studies to identify molecular targets within neural-invasive niches, such as the CXCR4/SDF-1 axis, which has been implicated in ACC progression. However, some studies still show significance in chemotherapy. A study concluding 174 HNACC patients reports that while no significant improvements in OS or DFS, patients receiving POCRT show better LCR and opioid-requiring pain-free survival than PORT, especially in patients with late clinical stage, positive surgical margins, and PI [18]. In the present study, POCRT also shows a tendency to benefit in patients with PI. However, The benefit of POCRT in these populations still needs to be confirmed by prospective RCTs.\u003c/p\u003e \u003cp\u003eExcept for adjuvant therapy, neoadjuvant therapy may become a solution to HNACC therapy. It is currently unclear whether neoadjuvant radiotherapy or neoadjuvant radiotherapy combined with chemotherapy provides benefits for patients with HNACC. Moreover, in the era of immunotherapy, neoadjuvant treatment based on immunotherapy is also worth exploring. Although the role of neoadjuvant therapy with chemotherapy combined with immunotherapy on the increase of survival benefit in head and neck squamous carcinoma has been supported by some clinical studies [32, 33], including the single-arm phase II clinical study of our group to be sent out in 2022 [34], the role of neoadjuvant therapy in HNACC remains to be explored. Neoadjuvant therapy may help HNACC achieve a better R0 resection rate in surgical resection as a way to improve patient prognosis. However, there are no prospective clinical studies on neoadjuvant therapy for HNACC, and its efficacy needs to be further explored.\u003c/p\u003e \u003cp\u003eWhile our study provides actionable insights, its retrospective design and single-center cohort limit generalizability. Heterogeneity in radiotherapy techniques (e.g., variable prophylactic dosing) and the small sample size for PORCT subgroups (n = 37) may have obscured treatment effects. Furthermore, the median follow-up of 42 months is insufficient for a tumor with a 10-year recurrence risk. Prospective multi-institutional trials with extended follow-up are imperative to validate our findings. Such studies should also incorporate next-generation sequencing to identify molecular subtypes responsive to specific therapies, as ACC’s heterogeneity demands personalized approaches.\u003c/p\u003e "},{"header":"Summary","content":"\u003cp\u003eIn summary, the current retrospective study showed that perineural invasion, failure to achieve safe margins and advanced clinical staging predicted poorer PFS and LFFS. For patients with adenoid cystic carcinoma with PI, postoperative adjuvant therapy significantly improved their PFS and LFFS rates compared to surgery alone, and when it came to the type of postoperative adjuvant therapy to be adopted, postoperative adjuvant radiotherapy significantly improved the prognosis of patients with PI. This study refines the role of adjuvant therapy in HNACC, emphasizing PORT’s value in PI-positive patients. By elucidating the interplay between tumor biology and treatment modality, our findings pave the way for biologically informed, risk-stratified management paradigms. Future efforts must prioritize translational research to bridge the gap between mechanistic understanding and clinical application in this enigmatic malignancy.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgements\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe thank all members of the group at the cancer center,Wuhan Union Hospital for their kindness and help. The study was approved by the Institutional Ethics Committee of Wuhan Union Hospital. Formal consent was waived because of the retrospective nature of this study. All individual-level data were anonymized and only available to authorized researchers.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the conception and drafting of the manuscript and have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis research didn\u0026rsquo;t receive any any form of sponsorship.\u003c/p\u003e\n\u003cp\u003eClinical trial number\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe author declares that he has no competing interests.\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThis research is approved by Ethics Committee of Wuhan Union Hospital.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBj\u0026oslash;rndal, K., et al., \u003cem\u003eSalivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA).\u003c/em\u003e Oral Oncol, 2011. \u003cstrong\u003e47\u003c/strong\u003e(7): p. 677-82.\u003c/li\u003e\n\u003cli\u003eChummun, S., et al., \u003cem\u003eAdenoid cystic carcinoma of the head and neck.\u003c/em\u003e Br J Plast Surg, 2001. \u003cstrong\u003e54\u003c/strong\u003e(6): p. 476-80.\u003c/li\u003e\n\u003cli\u003eCoca-Pelaz, A., et al., \u003cem\u003eAdenoid cystic carcinoma of the head and neck--An update.\u003c/em\u003e Oral Oncol, 2015. \u003cstrong\u003e51\u003c/strong\u003e(7): p. 652-61.\u003c/li\u003e\n\u003cli\u003eDel Signore, A.G. and U.C. Megwalu, \u003cem\u003eThe rising incidence of major salivary gland cancer in the United States.\u003c/em\u003e Ear Nose Throat J, 2017. \u003cstrong\u003e96\u003c/strong\u003e(3): p. E13-e16.\u003c/li\u003e\n\u003cli\u003eArgyris, P.P., et al., \u003cem\u003eLacrimal gland adenoid cystic carcinoma with high-grade transformation to myoepithelial carcinoma: report of a case and review of literature.\u003c/em\u003e Head Neck Pathol, 2013. \u003cstrong\u003e7\u003c/strong\u003e(1): p. 85-92.\u003c/li\u003e\n\u003cli\u003eCant\u0026ugrave;, G., \u003cem\u003eAdenoid cystic carcinoma. An indolent but aggressive tumour. Part A: from aetiopathogenesis to diagnosis.\u003c/em\u003e Acta Otorhinolaryngol Ital, 2021. \u003cstrong\u003e41\u003c/strong\u003e(3): p. 206-214.\u003c/li\u003e\n\u003cli\u003eCiccolallo, L., et al., \u003cem\u003eSurvival from salivary glands adenoid cystic carcinoma in European populations.\u003c/em\u003e Oral Oncol, 2009. \u003cstrong\u003e45\u003c/strong\u003e(8): p. 669-74.\u003c/li\u003e\n\u003cli\u003eDeAngelis, A.F., et al., \u003cem\u003eOutcomes of patients with adenoid cystic carcinoma of the minor salivary glands.\u003c/em\u003e Int J Oral Maxillofac Surg, 2011. \u003cstrong\u003e40\u003c/strong\u003e(7): p. 710-4.\u003c/li\u003e\n\u003cli\u003eCant\u0026ugrave;, G., \u003cem\u003eAdenoid cystic carcinoma. An indolent but aggressive tumour. Part B: treatment and prognosis.\u003c/em\u003e Acta Otorhinolaryngol Ital, 2021. \u003cstrong\u003e41\u003c/strong\u003e(4): p. 296-307.\u003c/li\u003e\n\u003cli\u003eMendenhall, W.M., et al., \u003cem\u003eRadiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck.\u003c/em\u003e Head Neck, 2004. \u003cstrong\u003e26\u003c/strong\u003e(2): p. 154-62.\u003c/li\u003e\n\u003cli\u003eCasler, J.D. and J.J. Conley, \u003cem\u003eSurgical management of adenoid cystic carcinoma in the parotid gland.\u003c/em\u003e Otolaryngol Head Neck Surg, 1992. \u003cstrong\u003e106\u003c/strong\u003e(4): p. 332-8.\u003c/li\u003e\n\u003cli\u003eGarden, A.S., et al., \u003cem\u003eThe influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation.\u003c/em\u003e Int J Radiat Oncol Biol Phys, 1995. \u003cstrong\u003e32\u003c/strong\u003e(3): p. 619-26.\u003c/li\u003e\n\u003cli\u003eErovic, B.M., et al., \u003cem\u003eOutcome analysis of 215 patients with parotid gland tumors: a retrospective cohort analysis.\u003c/em\u003e J Otolaryngol Head Neck Surg, 2015. \u003cstrong\u003e44\u003c/strong\u003e: p. 43.\u003c/li\u003e\n\u003cli\u003eLee, S.Y., B.H. Kim, and E.C. Choi, \u003cem\u003eNineteen-year oncologic outcomes and the benefit of elective neck dissection in salivary gland adenoid cystic carcinoma.\u003c/em\u003e Head Neck, 2014. \u003cstrong\u003e36\u003c/strong\u003e(12): p. 1796-801.\u003c/li\u003e\n\u003cli\u003eHsieh, R.C., et al., \u003cem\u003eA multicenter retrospective analysis of patients with salivary gland carcinoma treated with postoperative radiotherapy alone or chemoradiotherapy.\u003c/em\u003e Radiother Oncol, 2023. \u003cstrong\u003e188\u003c/strong\u003e: p. 109891.\u003c/li\u003e\n\u003cli\u003eCerda, T., et al., \u003cem\u003eA rationale for chemoradiation (vs radiotherapy) in salivary gland cancers? On behalf of the REFCOR (French rare head and neck cancer network).\u003c/em\u003e Crit Rev Oncol Hematol, 2014. \u003cstrong\u003e91\u003c/strong\u003e(2): p. 142-58.\u003c/li\u003e\n\u003cli\u003eEdition, S., S. Edge, and D. Byrd, \u003cem\u003eAJCC cancer staging manual.\u003c/em\u003e AJCC cancer staging manual, 2017.\u003c/li\u003e\n\u003cli\u003eHsieh, C.E., et al., \u003cem\u003eAdding concurrent chemotherapy to postoperative radiotherapy improves locoregional control but Not overall survival in patients with salivary gland adenoid cystic carcinoma-a propensity score matched study.\u003c/em\u003e Radiat Oncol, 2016. \u003cstrong\u003e11\u003c/strong\u003e: p. 47.\u003c/li\u003e\n\u003cli\u003eTsan, D.L., et al., \u003cem\u003eThe comparison between weekly and three-weekly cisplatin delivered concurrently with radiotherapy for patients with postoperative high-risk squamous cell carcinoma of the oral cavity.\u003c/em\u003e Radiat Oncol, 2012. \u003cstrong\u003e7\u003c/strong\u003e: p. 215.\u003c/li\u003e\n\u003cli\u003ePark, W., et al., \u003cem\u003eClinical outcomes and management of facial nerve in patients with parotid gland cancer and pretreatment facial weakness.\u003c/em\u003e Oral Oncol, 2019. \u003cstrong\u003e89\u003c/strong\u003e: p. 144-149.\u003c/li\u003e\n\u003cli\u003eZb\u0026auml;ren, P., et al., \u003cem\u003eElective neck dissection versus observation in primary parotid carcinoma.\u003c/em\u003e Otolaryngol Head Neck Surg, 2005. \u003cstrong\u003e132\u003c/strong\u003e(3): p. 387-91.\u003c/li\u003e\n\u003cli\u003eMichel, G., et al., \u003cem\u003eAdenoid cystic carcinoma of the paranasal sinuses: retrospective series and review of the literature.\u003c/em\u003e Eur Ann Otorhinolaryngol Head Neck Dis, 2013. \u003cstrong\u003e130\u003c/strong\u003e(5): p. 257-62.\u003c/li\u003e\n\u003cli\u003eMin, R., et al., \u003cem\u003eSalivary gland adenoid cystic carcinoma with cervical lymph node metastasis: a preliminary study of 62 cases.\u003c/em\u003e Int J Oral Maxillofac Surg, 2012. \u003cstrong\u003e41\u003c/strong\u003e(8): p. 952-7.\u003c/li\u003e\n\u003cli\u003eRenehan, A.G., et al., \u003cem\u003eClinico-pathological and treatment-related factors influencing survival in parotid cancer.\u003c/em\u003e Br J Cancer, 1999. \u003cstrong\u003e80\u003c/strong\u003e(8): p. 1296-300.\u003c/li\u003e\n\u003cli\u003eCarlson, M.L., et al., \u003cem\u003eOccult Temporal Bone Facial Nerve Involvement by Parotid Malignancies with Perineural Spread.\u003c/em\u003e Otolaryngol Head Neck Surg, 2015. \u003cstrong\u003e153\u003c/strong\u003e(3): p. 385-91.\u003c/li\u003e\n\u003cli\u003eGandolfi, M.M. and W. Slattery, 3rd, \u003cem\u003eParotid Gland Tumors and the Facial Nerve.\u003c/em\u003e Otolaryngol Clin North Am, 2016. \u003cstrong\u003e49\u003c/strong\u003e(2): p. 425-34.\u003c/li\u003e\n\u003cli\u003eBarrett, A.W. and P.M. Speight, \u003cem\u003ePerineural invasion in adenoid cystic carcinoma of the salivary glands: a valid prognostic indicator?\u003c/em\u003e Oral Oncol, 2009. \u003cstrong\u003e45\u003c/strong\u003e(11): p. 936-40.\u003c/li\u003e\n\u003cli\u003eKhan, A.J., et al., \u003cem\u003eAdenoid cystic carcinoma: a retrospective clinical review.\u003c/em\u003e Int J Cancer, 2001. \u003cstrong\u003e96\u003c/strong\u003e(3): p. 149-58.\u003c/li\u003e\n\u003cli\u003eAndry, G., et al., \u003cem\u003eManagement of salivary gland tumors.\u003c/em\u003e Expert Rev Anticancer Ther, 2012. \u003cstrong\u003e12\u003c/strong\u003e(9): p. 1161-8.\u003c/li\u003e\n\u003cli\u003eDodd, R.L. and N.J. Slevin, \u003cem\u003eSalivary gland adenoid cystic carcinoma: a review of chemotherapy and molecular therapies.\u003c/em\u003e Oral Oncol, 2006. \u003cstrong\u003e42\u003c/strong\u003e(8): p. 759-69.\u003c/li\u003e\n\u003cli\u003eGhosal, N., et al., \u003cem\u003ePhase II study of cisplatin and imatinib in advanced salivary adenoid cystic carcinoma.\u003c/em\u003e Br J Oral Maxillofac Surg, 2011. \u003cstrong\u003e49\u003c/strong\u003e(7): p. 510-5.\u003c/li\u003e\n\u003cli\u003eVos, J.L., et al., \u003cem\u003eNeoadjuvant immunotherapy with nivolumab and ipilimumab induces major pathological responses in patients with head and neck squamous cell carcinoma.\u003c/em\u003e Nat Commun, 2021. \u003cstrong\u003e12\u003c/strong\u003e(1): p. 7348.\u003c/li\u003e\n\u003cli\u003eFerrarotto, R., et al., \u003cem\u003ePilot Phase II Trial of Neoadjuvant Immunotherapy in Locoregionally Advanced, Resectable Cutaneous Squamous Cell Carcinoma of the Head and Neck.\u003c/em\u003e Clin Cancer Res, 2021. \u003cstrong\u003e27\u003c/strong\u003e(16): p. 4557-4565.\u003c/li\u003e\n\u003cli\u003eZhang, Z., et al., \u003cem\u003eNeoadjuvant Chemoimmunotherapy for the Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: A Single-Arm Phase 2 Clinical Trial.\u003c/em\u003e Clin Cancer Res, 2022. \u003cstrong\u003e28\u003c/strong\u003e(15): p. 3268-3276.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"HNACC, Postoperative treatment, Adjuvent chemotherapy, Adjuvent radiotherapy, Perineural invasion","lastPublishedDoi":"10.21203/rs.3.rs-6688245/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6688245/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePurpose: The aim of this study was to investigate whether postoperative treatment (POT) like postoperative radiotherapy (PORT) and postoperative radiochemotherapy (PORCT) is beneficial for patients with adenoid cystic carcinoma (ACC) of the head and neck compared with surgery alone.\u003c/p\u003e\n\u003cp\u003eMaterials and methods: This retrospective study included 114 patients with adenoid cystic\u003c/p\u003e\n\u003cp\u003eRESULTS: In the entire cohort, adjuvant therapy did not significantly improve progression-free survival (PFS) in patients with head and neck adenoid cystic carcinoma (HNACC) from January 2011 to August 2023, of whom 35 patients did not receive postoperative adjuvant therapy, 42 patients received PORT and 37patients received PORCT. Possible correlations between clinical parameters and outcomes were examined using Kaplan-Meier analysis and Cox proportional risk regression modeling.\u003c/p\u003e\n\u003cp\u003ePFS in ACC of the head and neck, neither in early-stage patients nor in patients with locally advanced disease. In this study, we found that the stage of HNACC, nerve invasion, the extent of surgical resection, and the level of Ki-67 could be regarded as independent prognostic factors affecting the PFS of patients with HNACC, while whether the HNACC originates from the major salivary glands (parotid, submandibular, and sublingual) or the minor salivary glands did not have a significant effect on the PFS of patients. Among these risk factors, .Among patients with perineural invasion (PI), postoperative radiotherapy (PORT) provided a significant local failure-free survival (LFFS) benefit compared to surgery alone, whereas postoperative radiochemotherapy (PORCT) showed no additional advantage.\u003c/p\u003e\n\u003cp\u003eConclusion: For HNACC with perineural invasion, the benefit of PORT is higher than that of surgical resection alone and PORCT.\u003c/p\u003e","manuscriptTitle":"A single center retrospective clinical study on head and neck adenoid cystic carcinoma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-28 08:39:47","doi":"10.21203/rs.3.rs-6688245/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"86ebfbb0-eb9e-4591-9ecf-69c7a9d4f263","owner":[],"postedDate":"May 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-16T06:23:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-28 08:39:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6688245","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6688245","identity":"rs-6688245","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}