迟发远处转移型头颈部腺样囊性癌临床预后特征分析OA

OBJECTIVE To investigate the long-term risk and population characteristics of distant metastasis in patients with head and neck adenoid cystic carcinoma(ACC),a malignancy characterized by prolonged persistence and slow progression.METHODS A retrospective analysis was conducted on 27 patients with pathologically confirmed ACC treated at Beijing Tongren Hospital between January 2000 and December 2024.All patients received standardized treatment and developed distant metastasis≥120 months after the initial diagnosis.Clinical,pathological,and follow-up data were collected and statistically analyzed.RESULTS Among the 27 patients,12 cases(44.4％)were male and 15 cases(55.6％)were female,with a median age at onset of 44.0 years.The nasal cavity and paranasal sinuses were the most common primary sites(37.0％).All patients underwent surgical treatment,of whom 55.6％received adjuvant radiotherapy.The median time to distant metastasis was 159.3 months,with the longest interval reaching 454.0 months.The lung was the predominant site of distant metastasis,accounting for 92.6％(25/27)of cases.Additionally,81.5％(22/27)of patients experienced local recurrence prior to the development of distant metastasis.The overall median survival time for all patients was 199.1 months,while the median survival after distant metastasis was 39.9 months.The overall mortality rate was 33.3％.Patients who died had a shorter median post-metastasis survival than those who remained alive(27.9 vs.42.4 months).CONCLUSION Head and neck adenoid cystic carcinoma demonstrates an insidious disease course with delayed yet persistent risk of distant metastasis,indicating a potentially aggressive malignant behavior that may be underestimated clinically.Current follow-up strategies appear insufficient for long-term monitoring.Therefore,extended and more rigorous surveillance is recommended for patients with ACC.