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To determine the therapeutic indications for systemic medical treatment in the management of adenoid cystic carcinoma (ACC) according to the clinical situation. The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group, which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. ACCs are rare tumors and there is currently insufficient evidence to indicate chemotherapy at the localized stage. At the metastatic stage, progression is often slow. In case of oligometastatic ACC, local treatment should be discussed. The most often indolent nature of polymetastatic ACC can allow management by active surveillance. Molecular screening is recommended, for abnormalities potentially accessible to targeted therapy. ACCs are rare tumors for which there are currently few effective medical treatments. It is therefore recommended to include patients in clinical trials. [ABSTRACT FROM AUTHOR]

• Inpatient palliative care use in urethral cancer increased from 6% to 28%. • Female sex and bone metastases predicted higher inpatient palliative care rates. • Hospitalization in some regions were associated with lower IPC use than in others. • Differences according to sex, metastatic site, and region should be addressed. In metastatic urethral cancer, temporal trends, and patterns of inpatient palliative care (IPC) use are unknown. Relying on the National Inpatient Sample (2006–2019), metastatic urethral cancer patients were stratified according to IPC use. Estimated annual percentage changes (EAPC) analyses and multivariable logistic regression models (LRM) for the prediction of IPC use were fitted. Of 1,106 metastatic urethral cancer patients, 199 (18%) received IPC. IPC use increased from 5.8 to 28.0% over time in the overall cohort (EAPC +9.8%; P < 0.001), from <12.5 to 35.1% (EAPC +11.2%; P < 0.001), and from <12.5 to 24.7% (EAPC +9.4%; P = 0.01) in respectively females and males. Lowest IPC rates were recorded in the Midwest (13.5%) vs. highest in the South (22.5%). IPC patients were more frequently female (44 vs. 37%), and more frequently exhibited bone metastases (45 vs. 34%). In multivariable LRM, female sex (multivariable odds ratio [OR] 1.46, 95% confidence interval [CI] 1.05–2.02; P = 0.02), and bone metastases (OR 1.46, 95%CI 1.02–2.10; P = 0.04) independently predicted higher IPC rates. Conversely, hospitalization in the Midwest (OR 0.53, 95%CI 0.31–0.91; P = 0.02), and in the Northeast (OR 0.48, 95%CI 0.28–0.82; P = 0.01) were both associated with lower IPC use than hospitalization in the West. IPC use in metastatic urethral cancer increased from a marginal rate of 5.8% to as high as 28%. Ideally, differences according to sex, metastatic site, and region should be addressed to improve IPC use rates. [ABSTRACT FROM AUTHOR]