Our experience with 184 previously untreated patients who had adenoid
cystic carcinoma of salivary gland origin is reviewed. Retrospective
staging was possible in all but nine patients who had minor salivary
gland primary tumors. Sixty-three percent of patients were diagnosed
as having stage I or stage II disease (stage I, 64 patients; stage
II, 47 patients), whereas 43 and 21 patients had stage III and IV
tumors, respectively. Grading was as follows: cribriform pattern only
(grade 1, 126 patients; 68%), mixed cribriform and solid features
(grade 2, 48 patients; 26%), and solid only (grade 3, 10 patients;
5%). Treatment was predominantly surgical (174 patients), and
relatively few patients received adjunctive, postoperative
irradiation (27 patients). Cumulative 10-year survival was 75%, 43%,
and 15% for stage I, stage II, and stage III and IV patients,
respectively, and cause-specific survival at 10 years was as high as
94% in patients with stage I disease. Only the clinical stage had a
significant impact on survival. Neither survival, regional metastases
(16 patients; 11%), nor distant dissemination (64 patients; 43%) was
predictable on the basis of tumor grade alone. The prognosis in
patients with early stage lesions may be better than has been
appreciated.