Figure S1 Association of primary tumor size with survival and time to metastasis. (A) Overall survival (OS) in months from initial diagnosis based on primary adenoid cystic carcinoma tumor size among patients with available longest unidimensional diameter (n = 34) at diagnosis. (B) Time in months from initial diagnosis to first visualization of metastasis based on primary tumor unidimensional measurements. **p < 0.01, *p < 0.05, log-rank testing.

Figure S2 Survival based on location of oligometastases at first visualization. (A) Overall survival (OS) in months from initial diagnosis compared among oligometastatic patients (n = 33) with involvement to exclusively the lungs versus other organs (liver, bone, brain, kidney) at first visualization. *p < 0.05, log-rank testing.

Figure S3 Outcomes based on time from diagnosis to metastasis. (A) Overall survival since diagnosis was compared between patients with synchronous (n = 2) and early metachronous (n = 17) metastases versus late metachronous (n = 23) metastases. Synchronous metastases are defined as those detected prior to or at the initial diagnosis of ACC, while early metachronous is defined as those detected ≤12 months after diagnosis, and late metachronous is defined as those detected >12 months after diagnosis. (B) Comparison of patients with early and late metachronous and the time between metastatic detection to start of systemic therapy. (C) Among patients with early versus late metachronous disease who received locally ablative therapy to their metastases, we compared the time to subsequent systemic therapy since local therapy.

Figure S4 Time to treatment and survival based on oligometastatic tumor burden at first visualization. (A) Time interval in months between visualization of oligometastases and treatment based on available unidimensional tumor burden measurements (n = 30) and (B) bidimensional tumor burden measurements (n = 23) at first visualization. (C) Overall survival (OS) in months from initial diagnosis among oligometastatic patients based on unidimensional tumor burden and (D) bidimensional tumor burden at first visualization. *p < 0.05, log-rank testing.

Figure S5 Survival based on oligometastatic tumor burden at first treatment. (A) Overall survival (OS) in months from initial diagnosis among oligometastatic patients based on unidimensional tumor burden at first treatment for metastatic disease.