Modem stereologic techniques enable unbiased, objective and reproducible assessment of histologic parameters. The purpose of this study was to investigate the prognostic impact of the volume-weighted mean volume of tumor nuclei (nuclear (V) over bar v) in 62 patients with adenoid cystic carcinoma (ACC) and to correlate nuclear (V) over bar v and some traditional prognostic parameters with treatment failures. The observation time of the patients ranged from 2 to 11 years. Disregarding the well known histopathological subtypes of ACC and using random sampling it was found that treatment failures, i.e. inability to eradicate the disease and recurrences, were more often seen in specimens with small nuclear (V) over bar v when-compared to non-failures. Using a cut-off point of 250 mu m(3) the prognostic significance of nuclear (V) over bar v was 0.0177 by log rank analysis. For tumor stage vs. treatment failures/nonfailures log rank analysis revealed p=0.0147. Cox regression analysis left only the nuclear (V) over bar v (p=0.0234) as a prognostic factor. Estimations of nuclear (V) over bar v appears to be a reliable indicator of short term treatment failures in ACC.

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