{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:07:44Z","timestamp":1777561664794,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"eijing Hope Run Special Fund of Cancer Foundation of China","award":["LC2017L04"],"award-info":[{"award-number":["LC2017L04"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    Adenoid cystic carcinoma (ACC) is an aggressive cancer that often leads to poor prognosis, especially when it has metastasized. The prognostic significance of primary tumor surgery (PTS) for ACC with distant metastasis (DM) at the time of diagnosis has not been extensively studied.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Using data from the surveillance, epidemiology, and end results (SEER) database from 2010 to 2019, we identified patients with ACC in head and neck region and synchronous DM. We evaluated the effect of PTS on different patterns of metastasis using Kaplan\u2013Meier analysis, log-rank tests, and multivariate Cox regression analysis to assess the therapeutic benefit of PTS in the overall cohort and various subgroups.\n                    <jats:bold>Results:<\/jats:bold>\n                    Of the 192 identified patients with synchronous metastatic ACC of head and neck, 91 (47.4%) underwent PTS. Patients who received PTS had significantly better survival than nonsurgical patients (median overall survival: 19 vs 43 months,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .006). Cox regression analysis also showed that PTS was associated with improved survival (HR = .46, 95% CI: 0.42-0.88;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .028). In sub-analyses, except for patients with liver metastases [overall survival (OS),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .107, cancer-specific survival (CSS),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .153], PTS consistently conferred significant survival benefits in patients with bone metastases (OS,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .041, CSS,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .065) and lung metastases (OS,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .016, CSS,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .027). PTS also led to better survival in patients who did not receive radiotherapy (median OS: 13 vs 52 months,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .007).\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Our study suggests that PTS in metastatic ACC patients of head and neck improved overall and CSS, particularly in those with bone or lung metastases and those who did not receive radiotherapy. However, further prospective studies are needed to confirm these findings, and the indications for PTS in metastatic ACC should be carefully evaluated by a multidisciplinary board.\n                  <\/jats:p>","DOI":"10.1177\/01455613231207262","type":"journal-article","created":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T02:15:46Z","timestamp":1697854546000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Significance of Primary Tumor Surgery in Adenoid Cystic Carcinoma Patients With Distant Metastases at Diagnosis: A Population-Based Database Analysis in Head and Neck Region"],"prefix":"10.1177","volume":"105","author":[{"given":"Han","family":"Li","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixuan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7354-774X","authenticated-orcid":false,"given":"Shaoyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2015.04.005"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbcan.2021.188523"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-68074-3"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2022.105945"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10400"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13005-020-00226-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815627637"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.01.009"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001302"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1673355"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27143"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2147\/cmar.S172725"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.11659"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15030900"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2621"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2011.88"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-09015-1"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-023-02166-5"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature22079"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10380"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2011.11.006"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26516"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23976"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.05.014"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23821"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2021.1019"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14225698"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5653"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.Ccr-21-1061"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32754"}],"container-title":["Ear, 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