High-grade transformation of acinic cell carcinoma: An inadequately treated entity?

Ashish Chintakuntlawar, Wonwoo Shon, Michele Erickson-Johnson, Elizabeth Bilodeau, Sarah M. Jenkins, Jennifer A. Davidson, Michael G. Keeney, Michael Rivera, Daniel L. Price, Eric J. Moore, Kerry D. Olsen, Jan Kasperbauer, Robert L. Foote, Katharine A. Price, Joaquín J. García

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Abstract

Objective Acinic cell carcinoma (AcCC) is an uncommon salivary gland malignancy. We aim to characterize the clinical and pathologic characteristics of AcCC with and without high-grade transformation (HGT). Importantly, cases of mammary analogue secretory carcinoma, a recently described histologic mimic of AcCC, have been excluded by using cytogenetics and molecular studies. Study Design Archival surgical pathology material was obtained for patients diagnosed with AcCC at Mayo Clinic Rochester between 1990 and 2010. Tumors harboring the ETV6-NTRK3 fusion transcript were excluded from analysis by using cytogenetics and molecular studies. Tumors with HGT were characterized by areas with an infiltrative growth pattern, nuclear anaplasia, prominent nucleoli, brisk mitotic activity, geographic necrosis, and stromal desmoplasia. Demographic and clinical data were extracted from the medical records. Results AcCC with HGT was seen in 8 of 48 cases (17%). Patients with AcCC with HGT were significantly older than patients without HGT (median 69 vs 54 years; P = .04). Angiolymphatic invasion was more common in AcCC with HGT (P = .02). Relapse-free survival and overall survival were significantly worse for cases of AcCC with HGT (hazard ratio 10.4 and 9.3, respectively; P < .0001 for both comparisons). Locoregional recurrence-free survival was not significantly different (P = .12), but distant metastases-free survival was significantly worse in patients with HGT compared with non-HGT patients (P < .0001). Conclusions Prognosis for overall survival and distant relapse for AcCC patients with HGT is significantly worse than that for patients without HGT.

Original languageEnglish (US)
Pages (from-to)542-549
Number of pages8
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume121
Issue number5
DOIs
StatePublished - May 1 2016

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Acinar Cell Carcinoma
Survival
Recurrence
Anaplasia
Neoplasms
Surgical Pathology
Cytogenetic Analysis
Salivary Glands
Cytogenetics
Medical Records
Necrosis
Demography
Neoplasm Metastasis

ASJC Scopus subject areas

  • Surgery
  • Pathology and Forensic Medicine
  • Oral Surgery
  • Dentistry (miscellaneous)
  • Radiology Nuclear Medicine and imaging

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High-grade transformation of acinic cell carcinoma : An inadequately treated entity? / Chintakuntlawar, Ashish; Shon, Wonwoo; Erickson-Johnson, Michele; Bilodeau, Elizabeth; Jenkins, Sarah M.; Davidson, Jennifer A.; Keeney, Michael G.; Rivera, Michael; Price, Daniel L.; Moore, Eric J.; Olsen, Kerry D.; Kasperbauer, Jan; Foote, Robert L.; Price, Katharine A.; García, Joaquín J.

In: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Vol. 121, No. 5, 01.05.2016, p. 542-549.

Research output: Contribution to journalArticle

Chintakuntlawar, A, Shon, W, Erickson-Johnson, M, Bilodeau, E, Jenkins, SM, Davidson, JA, Keeney, MG, Rivera, M, Price, DL, Moore, EJ, Olsen, KD, Kasperbauer, J, Foote, RL, Price, KA & García, JJ 2016, 'High-grade transformation of acinic cell carcinoma: An inadequately treated entity?', Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, vol. 121, no. 5, pp. 542-549. https://doi.org/10.1016/j.oooo.2016.01.011
Chintakuntlawar, Ashish ; Shon, Wonwoo ; Erickson-Johnson, Michele ; Bilodeau, Elizabeth ; Jenkins, Sarah M. ; Davidson, Jennifer A. ; Keeney, Michael G. ; Rivera, Michael ; Price, Daniel L. ; Moore, Eric J. ; Olsen, Kerry D. ; Kasperbauer, Jan ; Foote, Robert L. ; Price, Katharine A. ; García, Joaquín J. / High-grade transformation of acinic cell carcinoma : An inadequately treated entity?. In: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2016 ; Vol. 121, No. 5. pp. 542-549.
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title = "High-grade transformation of acinic cell carcinoma: An inadequately treated entity?",
abstract = "Objective Acinic cell carcinoma (AcCC) is an uncommon salivary gland malignancy. We aim to characterize the clinical and pathologic characteristics of AcCC with and without high-grade transformation (HGT). Importantly, cases of mammary analogue secretory carcinoma, a recently described histologic mimic of AcCC, have been excluded by using cytogenetics and molecular studies. Study Design Archival surgical pathology material was obtained for patients diagnosed with AcCC at Mayo Clinic Rochester between 1990 and 2010. Tumors harboring the ETV6-NTRK3 fusion transcript were excluded from analysis by using cytogenetics and molecular studies. Tumors with HGT were characterized by areas with an infiltrative growth pattern, nuclear anaplasia, prominent nucleoli, brisk mitotic activity, geographic necrosis, and stromal desmoplasia. Demographic and clinical data were extracted from the medical records. Results AcCC with HGT was seen in 8 of 48 cases (17{\%}). Patients with AcCC with HGT were significantly older than patients without HGT (median 69 vs 54 years; P = .04). Angiolymphatic invasion was more common in AcCC with HGT (P = .02). Relapse-free survival and overall survival were significantly worse for cases of AcCC with HGT (hazard ratio 10.4 and 9.3, respectively; P < .0001 for both comparisons). Locoregional recurrence-free survival was not significantly different (P = .12), but distant metastases-free survival was significantly worse in patients with HGT compared with non-HGT patients (P < .0001). Conclusions Prognosis for overall survival and distant relapse for AcCC patients with HGT is significantly worse than that for patients without HGT.",
author = "Ashish Chintakuntlawar and Wonwoo Shon and Michele Erickson-Johnson and Elizabeth Bilodeau and Jenkins, {Sarah M.} and Davidson, {Jennifer A.} and Keeney, {Michael G.} and Michael Rivera and Price, {Daniel L.} and Moore, {Eric J.} and Olsen, {Kerry D.} and Jan Kasperbauer and Foote, {Robert L.} and Price, {Katharine A.} and Garc{\'i}a, {Joaqu{\'i}n J.}",
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T1 - High-grade transformation of acinic cell carcinoma

T2 - An inadequately treated entity?

AU - Chintakuntlawar, Ashish

AU - Shon, Wonwoo

AU - Erickson-Johnson, Michele

AU - Bilodeau, Elizabeth

AU - Jenkins, Sarah M.

AU - Davidson, Jennifer A.

AU - Keeney, Michael G.

AU - Rivera, Michael

AU - Price, Daniel L.

AU - Moore, Eric J.

AU - Olsen, Kerry D.

AU - Kasperbauer, Jan

AU - Foote, Robert L.

AU - Price, Katharine A.

AU - García, Joaquín J.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objective Acinic cell carcinoma (AcCC) is an uncommon salivary gland malignancy. We aim to characterize the clinical and pathologic characteristics of AcCC with and without high-grade transformation (HGT). Importantly, cases of mammary analogue secretory carcinoma, a recently described histologic mimic of AcCC, have been excluded by using cytogenetics and molecular studies. Study Design Archival surgical pathology material was obtained for patients diagnosed with AcCC at Mayo Clinic Rochester between 1990 and 2010. Tumors harboring the ETV6-NTRK3 fusion transcript were excluded from analysis by using cytogenetics and molecular studies. Tumors with HGT were characterized by areas with an infiltrative growth pattern, nuclear anaplasia, prominent nucleoli, brisk mitotic activity, geographic necrosis, and stromal desmoplasia. Demographic and clinical data were extracted from the medical records. Results AcCC with HGT was seen in 8 of 48 cases (17%). Patients with AcCC with HGT were significantly older than patients without HGT (median 69 vs 54 years; P = .04). Angiolymphatic invasion was more common in AcCC with HGT (P = .02). Relapse-free survival and overall survival were significantly worse for cases of AcCC with HGT (hazard ratio 10.4 and 9.3, respectively; P < .0001 for both comparisons). Locoregional recurrence-free survival was not significantly different (P = .12), but distant metastases-free survival was significantly worse in patients with HGT compared with non-HGT patients (P < .0001). Conclusions Prognosis for overall survival and distant relapse for AcCC patients with HGT is significantly worse than that for patients without HGT.

AB - Objective Acinic cell carcinoma (AcCC) is an uncommon salivary gland malignancy. We aim to characterize the clinical and pathologic characteristics of AcCC with and without high-grade transformation (HGT). Importantly, cases of mammary analogue secretory carcinoma, a recently described histologic mimic of AcCC, have been excluded by using cytogenetics and molecular studies. Study Design Archival surgical pathology material was obtained for patients diagnosed with AcCC at Mayo Clinic Rochester between 1990 and 2010. Tumors harboring the ETV6-NTRK3 fusion transcript were excluded from analysis by using cytogenetics and molecular studies. Tumors with HGT were characterized by areas with an infiltrative growth pattern, nuclear anaplasia, prominent nucleoli, brisk mitotic activity, geographic necrosis, and stromal desmoplasia. Demographic and clinical data were extracted from the medical records. Results AcCC with HGT was seen in 8 of 48 cases (17%). Patients with AcCC with HGT were significantly older than patients without HGT (median 69 vs 54 years; P = .04). Angiolymphatic invasion was more common in AcCC with HGT (P = .02). Relapse-free survival and overall survival were significantly worse for cases of AcCC with HGT (hazard ratio 10.4 and 9.3, respectively; P < .0001 for both comparisons). Locoregional recurrence-free survival was not significantly different (P = .12), but distant metastases-free survival was significantly worse in patients with HGT compared with non-HGT patients (P < .0001). Conclusions Prognosis for overall survival and distant relapse for AcCC patients with HGT is significantly worse than that for patients without HGT.

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