Clinical characteristics, therapy and prognosis of parotid acinar cell carcinoma

Objective: This study was aimed to investigate the clinical characteristics, therapy and prognosis of parotid acinar cell carcinoma (ACC). Methods: We retrospectively reviewed 72 patients with parotid ACC who were treated in Zhejiang Cancer Hospital from January 1999 to December 2011. Results: There were 35 males and 37 females with the median age of 40 years. In addition, 34 patients received initial therapy in our hospital and 38 patients received further treatment after surgery in other hospitals. Of 38 patients undergoing non-initial therapy, 6 patients suffered recurrence after surgery in other hospitals and 32 patients needed extended resection after only enucleation in other hospitals. Fifty-two patients underwent superficial parotidectomy and 16 patients underwent total parotidectomy. Five patients had surgery and postoperative radiotherapy in our hospital. Four patients who developed local recurrence refused reoperation and then received radiation therapy instead of surgery. Chemotherapy (cisplatin) was performed in 1 patient with lung and pleura metastasis. Sixty-six patients were available for follow-up with a median time of 24 months (range: 3-192 months). The post-operative 3-year and 5-year survival rate were 95.5% and 90.9%, respectively. Conclusion: The initial surgery is crucial for the prognosis of parotid ACC. Nonstandard enuclration may cause the implantation of tumor cells, leading to post-operative local recurrence. Parotid ACC patients with lymph node metastasis have high risk for post-operative recurrence. Surgery with superficial or total parotidectomy and postoperative radiotherapy could achieve the satisfying disease control.