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Stage Means More Than Grade in Adenoid Cystic Carcinoma

Stage Means More Than Grade in Adenoid Cystic Carcinoma

Adenoid cystic carcinoma(ACC) is a type of cancer that usually affects the salivary glands and the surrounding areas like the head and neck. However, it can also occur in other body parts like breast tissue, skin, prostate, or cervix. 

This cancer type is relatively quite rare compared to other cancers. It has its own way of staging. The tumours may be solid, hollow, round, or have holes in them. Women are more prone to get this cancer than men and it commonly occurs in the age group of 40 to 60 year-olds.

Symptoms of ACC

As this cancer affects numerous body parts, symptoms depend on the body part involved. For the ACC of the salivary gland, one may have facial pain, drooping, or numbness in the lips and surrounding areas. If ACC affects your tear glands, one may face vision-related issues, bulging eyes, and also pain and swelling in the areas nearby to tear glands. ACC affecting your skin can cause pain, bleeding, pus collection, loss of hair, and increased sensitivity in the affected area. If it affects your breast, then a movable is usually developed near the areola. In the case of the cervix, it can cause vaginal discharge and bleed, and pain. The ACC of the prostate can cause frequent urination and poor urine flow.

Staging in ACC

Staging in ACC is done using the TNM staging system which is also known as the AJCC system. TNM is an acronym for Tumour Node Metastasis. Here ‘T’ means where the tumour is located and how big it is. N or node brings up the question of whether cancer has spread to the lymph nodes or not. Finally, ‘M’ means metastasis ie, if cancer has spread to other body parts or not. Diagnosis of the patients is used to answer these questions and also to come up with the stage of ACC. There are five stages ranging from stage 0 which goes up to stage IV. 

So, a stage where the tumour is non-invasive is usually T1 or T2 while lymph nodes are not affected(N0) and there is no metastasis(M0). Stage II means an invasive tumour but lymph nodes are still not affected. Stage III shows that the tumour has spread to the lymph nodes but has no metastasis. Stage IV happens when a tumour is invasive that may or may not have metastasis and probably affected the lymph nodes. Stage IV has subcategories i.e., IVA, IVB, and IVC.

Importance of staging in ACC

The stage and grade of the cancerous growth of adenoid cystic carcinoma play an important role in determining the severity of the various stages like stage II. Staging describes the growth of cancer or the location or location of the tumour. It also helps explain if the tumour has spread or metastasized to other parts of the body and if so, which parts have infiltrated and are affected. 

Doctors use a variety of diagnostic tools to assess the stage of a tumour. The stage of the tumour is determined only after all necessary tests and scans have been completed. Knowing the stage of the tumour is very important in determining the appropriate treatment strategy. The doctor will follow the staging tools to select the best treatment plan that best suits the patient. It helps them predict a person’s prognosis as well as their recovery and survival potential. 

The description of the stage depends on the type of cancer. There are many staging systems, but the most preferred and appropriate way to explain the staging of adenoid cystic carcinoma (ACC) is to use the TNM staging system. 

In fact, some studies have identified clinical staging as one of the most important factors for not getting favourable outcomes. It also affects survival and recurrence. Presence of lymph nodes getting affected means higher chances of metastasis in the future but doesn’t affect the local recurrence. So, it affects the survival of the patient adversely. Grade plays an important role in prognosis and might be the marker for the outcomes of the treatment. High-grade tumours mean lower chances of survival, frequent recurrence, and more relapses.

Actually, the origin also affects the outcome of clinical treatment. For example, ACC of the salivary glands has a high recurrence rate. However, it doesn’t involve metastasis. In a nutshell, we can say that a high-grade tumour corresponds to recurrence while the lymph node involvement affects the survival of the patients.

Summing up 

We discussed ACC, its symptoms, and how all body parts are affected by it. We also talked about the staging system here. A staging system is very crucial in determining the stage of ACC. It directly correlates to the favourable outcome of the clinical trials and also the survival rate. So, it is of paramount importance while diagnosing and coming up with a treatment plan for ACC. There are some ongoing debates questioning whether the current staging system is effective in dealing with this disease. But further research and clinical trials are needed to answer this question and also to come up with a better staging system.


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