To report long‐term local control in patients with adenoid cystic cancer (ACC) of the head and neck managed by surgery and identify factors predictive for local failure.

Single‐institution retrospective cohort study.

Eighty‐seven patients who had surgery for ACC between 1985 and 2009 were identified. Patient, tumor, and treatment characteristics were recorded. Local recurrence‐free survival (LRFS) was recorded by the Kaplan‐Meier method. Predictors of local control were identified.

The median age was 54 years. Seventy‐two (83%) patients had perineural invasion, 61 (70%) had close/positive margins, and 58 (67%) had pT 1T2. Fifty‐nine (68%) patients had postoperative radiation therapy (PORT). With a median follow‐up of 85 months, the 10‐year LRFS was 78.7%. There were 14 local recurrences. On multivariable analysis, pathological tumor (T)3T4 stage and no PORT were independent predictors for local failure. Patients with no PORT had a 13‐fold increased risk of local failure compared to patients treated with PORT (P = 0.003) after adjusting for stage.

After adjusting for T stage, patients who do not get PORT are more likely to have local recurrence.

4. Laryngoscope, 127:2265–2269, 2017