Demographic and prognostic indicators of Adenoid cystic carcinoma in the head and neck: A National Cancer Database...

Adenoid cystic carcinoma (ACC) is a rare malignancy comprising just 1 % of all head and neck malignancies. To date, there are no National Cancer Database (NCDB) studies evaluating the demographic and prognostic factors of ACC of the head and neck. Existing studies have only utilized single-institution cohorts, other databases, and narrowly defined populations, resulting in a fragmented view. This study aims to address this by providing an NCDB analysis of all patients with ACC in the head and neck.

Utilizing retrospective 2004-2021 NCDB data, this study analyzed several variables including patient demographics, prognostic factors, and treatment modalities. Kaplan-Meier survival curves were plotted for overall survival, Cox Regression Models were utilized to assess hazard ratios (HRs), and binomial regression for surgical likelihood.

ACC was most frequently located in the major salivary glands (45.2 %). The mean age at diagnosis was 58.75 years. Surgical intervention significantly improved survival, with hazard ratios ranging from 0.302 to 0.451 compared to no surgery. Overall, 69.8 % of patients received surgery. Factors associated with lower surgical likelihood included higher Charlson-Deyo scores, uninsured status, and older age. Tumor site influenced outcomes: surgically accessible sites such as the gums and oral cavity were associated with improved survival (HR 0.875), while less accessible sites like the nasopharynx and pharynx had worse outcomes (HR 1.868 and 1.123, respectively).

Surgical treatment confers a significant survival advantage in head and neck ACC. Disparities in surgical receipt based on insurance status, comorbidities, age, and tumor location highlight the need for strategies to improve equitable access to care.