Laryngeal adenoid cystic carcinoma: Radical or conservative surgery?

Am J Otolaryngol. 2021 Jul-Aug;42(4):102974. doi: 10.1016/j.amjoto.2021.102974. Epub 2021 Feb 16.


Purpose: The present paper describes our experience in surgical treatment of laryngeal ACC, and discuss the effectiveness of conservative surgery.

Methods: We retrospectively reviewed the clinical charts of 17 patients with laryngeal ACC treated surgically at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) from November 1989 to April 2020.

Results: Fourteen patients underwent partial laryngectomy, and three had a total laryngectomy. Five patients (29%) experienced a laryngeal ACC relapse after a disease-free survival of 66.6 ± 50.1 months. The distant metastasis rate was 17%. At latest follow-up, two patients had died of distant metastatic disease after 156 and 243 months.

Conclusions: Radical surgery for laryngeal ACC does not warrant free margins and even cases with positive deep margins rarely experience any relapsing disease. We recommend that surgical treatment for laryngeal ACC be as conservative as possible.

Keywords: Adenoid cystic carcinoma; Conservative approach; Laryngeal cancer; Partial laryngectomy; Total laryngectomy.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Adenoid Cystic / mortality
  • Carcinoma, Adenoid Cystic / surgery*
  • Conservative Treatment / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Larynx / surgery*
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome