BACKGROUND Patterns of nodal involvement in adenoid cystic carcinoma (ACC) of the head and neck have not been sufficiently assessed to guide a decision of prophylactic neck dissection (ND). The objective of this study is to analyse the influence of ND on event-free survival (EFS) for patients with cN0 ACC. PATIENTS AND METHODS A multicentre prospective study was conducted between 2009 and 2018. Patients presenting cN0 non-metastatic ACC on any site, and who received surgery on the tumour, were included. EFS was the main judgement criterion. A comparative survival analysis between the groups that received a ND versus those that did not was performed, using a propensity score. Analyses were carried out using the R software. RESULTS Between 2009 and 2018, 322 patients with cN0 ACC were included, out of which 58% were female. The average age was 53 years. Tumours were in minor salivary glands in 58% of cases, and 52% had T3/T4 stages. ND was performed on 46% of patients. Out of them, seven had histological lymph node invasion, out of which six had tumour infiltration in the mucosa of oral cavity. After propensity score, the median EFS for N0 patients with ND was 72 months (95% Confidence Interval (CI) [48-81]), compared to 73 months (95% CI [52-85]) for patients without ND (HR = 1.33; 95% CI [0.82-2.16]; p = 0.2). CONCLUSION ND of cN0 patients does not provide any benefit on EFS, which suggests that its application on such patients is not necessary.

中文翻译：

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cN0腺样囊性癌患者应行颈清扫术吗？REFCOR倾向得分匹配研究。

背景技术尚未充分评估头颈部腺样囊性癌（ACC）的淋巴结转移模式，以指导预防性颈清扫术（ND）的决策。这项研究的目的是分析ND对cN0 ACC患者的无事件生存（EFS）的影响。患者与方法在2009年至2018年之间进行了一项多中心前瞻性研究。研究对象包括在任何部位出现cN0非转移性ACC并在肿瘤上接受手术的患者。EFS是主要的判断标准。使用倾向评分，对接受ND的组与未接受ND的组进行比较生存分析。使用R软件进行分析。结果2009年至2018年，共纳入322例cN0 ACC患者，其中58％为女性。平均年龄为53岁。58％的病例位于小唾液腺中，而T3 / T4期则占52％。在46％的患者中进行了ND。其中7例具有组织学淋巴结浸润，其中6例在口腔粘膜中浸润了肿瘤。倾向得分后，N0 ND患者的中位数EFS为72个月（95％置信区间（CI）[48-81]），而无ND（HR）患者为73个月（95％CI [52-85]） ＝ 1.33； 95％CI [0.82-2.16]； p ＝ 0.2）。结论cN0患者的ND对EFS没有任何益处，这表明在此类患者中应用它是不必要的。其中六个在口腔粘膜中有肿瘤浸润。倾向得分后，N0 ND患者的中位数EFS为72个月（95％置信区间（CI）[48-81]），而无ND（HR）患者为73个月（95％CI [52-85]） ＝ 1.33； 95％CI [0.82-2.16]； p ＝ 0.2）。结论cN0患者的ND对EFS没有任何益处，这表明在此类患者中应用它是不必要的。其中六个在口腔粘膜中有肿瘤浸润。倾向得分后，N0 ND患者的中位数EFS为72个月（95％置信区间（CI）[48-81]），而无ND（HR）患者为73个月（95％CI [52-85]） ＝ 1.33； 95％CI [0.82-2.16]； p ＝ 0.2）。结论cN0患者的ND对EFS没有任何益处，这表明在此类患者中应用它是不必要的。