Adenoid Cystic Carcinoma of the Minor Salivary Glands: Long-term Survival With Planned Combined Therapy
Adenoid cystic carcinomas account for approximately 35% of minor salivary gland tumors.1 Furthermore, 58% to 71% of all adenoid cystic carcinomas arise in the minor glands.2,3 Traditional treatment has yielded disappointing survival figures. While survival is respectable at three years, it "drops sharply at five years and is disastrous at six to eight years."4 Treatment has consisted of wide excision. The recurrence rate is exceedingly high. When the lesion recurs, it is excised again, if possible. If this is not possible, it is then irradiated. Irradiation usually produces a response but, again, recurrence is expected. The high long-term failure rate has led Conley and Dingman2 to advocate that the initial operative procedure be as large as can be devised for the given anatomic location. Even with this approach, Conley and Dingman have