Histologic grade as prognostic indicator for mucoepidermoid carcinoma: a population-level analysis of 2400 patients

Head Neck. 2014 Feb;36(2):158-63. doi: 10.1002/hed.23256. Epub 2013 Jun 14.

Abstract

Background: Mucoepidermoid carcinoma (MEC) is an uncommon malignancy. To the best of our knowledge, this is the largest study investigating disease-specific survival (DSS) of parotid MEC and the first population-level study of the distribution of nodal metastases.

Methods: Patients with MEC of the parotid gland were identified in the Surveillance, Epidemiology, and End Results (SEER) database (1988-2009).

Results: We identified 2400 patients with MEC: 522 low grade, 1137 intermediate grade, and 741 high grade. Five-year DSS rates for low-grade, intermediate-grade, and high-grade MEC were 98.8%, 97.4%, and 67.0%, respectively (p < .001). Negative prognostic factors included high grade, increasing patient age, and tumor size, extraparenchymal extension, nodal metastases, and distant metastases. High-grade MEC was more likely to have lymph node metastases in levels I to III (34.0%) than low-grade (3.3%) and intermediate-grade MEC (8.1%; p < .001).

Conclusion: Grade influences the prognosis and distribution of nodal metastases. Results indicate that management guidelines should vary based on grade.

Keywords: lymph node metastases; mucoepidermoid carcinoma; parotid gland; salivary gland carcinoma; survival.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Mucoepidermoid / epidemiology
  • Carcinoma, Mucoepidermoid / pathology*
  • Carcinoma, Mucoepidermoid / radiotherapy
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Parotid Neoplasms / epidemiology
  • Parotid Neoplasms / pathology*
  • Parotid Neoplasms / radiotherapy
  • Prognosis
  • Risk Factors
  • Treatment Outcome
  • United States / epidemiology