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Al-Qurayshi Z, Sullivan CB, Allison DB, Buchakjian MR. Presentation and outcomes of patients with clinically T1-2, N0 parotid mucoepidermoid carcinoma: The roles of elective neck dissection and adjuvant radiotherapy. Head Neck 2022; 44:2151-2161. [PMID: 35731030 PMCID: PMC9544346 DOI: 10.1002/hed.27128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 05/08/2022] [Accepted: 06/07/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives Examine the role of elective neck dissection (END) and adjuvant radiotherapy (RT) in early‐stage clinically N0 parotid mucoepidermoid carcinoma (MEC). Methods The study is a retrospective analysis of the National Cancer Database, 2004–2016. The study population included adult patients with MEC who underwent parotidectomy. Results A total of 1233 patients were included. Histopathology demonstrated well, moderately, and poorly differentiated MEC 47.12%, 39.98%, and 12.90% of the time, respectively. END was performed in 78.67% of patients, resulting in nodal upstaging in 4.43% and identification of extracapsular extension (ECE) in 0.72%. RT was utilized in 67.33% of patients with advanced pathological features. Neither END nor RT improved overall survival separately (p < 0.05) or combined (adjusted HR: 1.19, 95%CI: 0.52, 2.70, p = 0.68). Conclusion This study provides an epidemiological perspective regarding patients with clinically T1‐2, N0 MEC. There was no observed survival advantage with END and RT.
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Affiliation(s)
- Zaid Al-Qurayshi
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | - Derek B Allison
- Department of Pathology & Laboratory Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Marisa R Buchakjian
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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Nachtsheim L, Prinz J, Arolt C, Quaas A, Meyer M, Klußmann JP, Wolber P. [Novel therapeutic approaches for salivary gland carcinomas]. Laryngorhinootologie 2022; 101:876-881. [PMID: 35320850 DOI: 10.1055/a-1792-2246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Novel therapeutic options for the treatment of salivary gland malignancies have emerged due to the improvement and distribution of molecular pathological testing methods and the availability of targeted therapies. Since they are less toxic, these new agents are a valuable alternative to conventional cytotoxic chemotherapy. On the one hand, there are new entity-specific therapies such as NTRK inhibitor therapy for secretory carcinomas and axitinib therapy for adenoid cystic carcinomas. Moreover, cross-entity therapeutics such as antiandrogenic therapy, HER2 inhibition, and PI3K inhibition are also coming to the fore. For metastatic/recurrent salivary gland carcinomas that cannot be treated with targeted therapy, platinum-based chemotherapies continue to be therapy of choice.
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Affiliation(s)
- Lisa Nachtsheim
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Universität zu Köln Medizinische Fakultät, Koln, Germany
| | - Johanna Prinz
- Klinik für Innere Medizin I, Universität zu Köln Medizinische Fakultät, Koln, Germany
| | - Christoph Arolt
- Klinik für Pathologie, Universität zu Köln Medizinische Fakultät, Koln, Germany
| | - Alexander Quaas
- Klinik für Pathologie, Universität zu Köln Medizinische Fakultät, Koln, Germany
| | - Moritz Meyer
- Hals- Nasen- Ohrenklinik, Universitätsklinikum Essen, Essen, Germany
| | - Jens Peter Klußmann
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Universität zu Köln Medizinische Fakultät, Koln, Germany
| | - Philipp Wolber
- Klinik und Poliklinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Universität zu Köln Medizinische Fakultät, Koln, Germany
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Mucoepidermoid carcinoma of the head and neck: CRTC1/3 MAML 2 translocation and its prognosticators. Eur Arch Otorhinolaryngol 2021; 279:2573-2581. [PMID: 34405264 PMCID: PMC8986707 DOI: 10.1007/s00405-021-07039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/10/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Mucoepidermoid carcinoma (MEC) of the head and neck is a prevalent malignant salivary gland tumour with a reported good outcome. The aim of this study was to report the outcome in our centre. METHODS A retrospective chart analysis with survival analyses was performed combined with fluorescence in situ hybridization (FISH) analysis to assess CRTC1/3 MAML 2 fusion gene presence. RESULTS Sixty-four cases of MEC were identified. Median age at presentation was 51.4 years with a predominance for parotid gland involvement. Five, 10- and 20- year disease-free survival was 98%, 90% and 68%, respectively. Overall survival was 94%, 90% and 64%, respectively. Local recurrence was seen up to 14 years after primary diagnosis; distant metastases were diagnosed up to 17 years later. The overall recurrence rate was less than 20 per cent. CRTC1/3 MAML 2 fusion gene presence showed no survival benefit. CONCLUSION MEC of the head and neck has a favorable outcome with the exception of high-grade MEC. PNI and nodal involvement are not rare. CRTC1/3 MAML 2 fusion gene presence showed no survival benefit. The tendency for late onset of loco-regional and distant recurrence should not be underestimated.
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Okumura Y, Nakano S, Murase T, Ueda K, Kawakita D, Nagao T, Kusafuka K, Urano M, Yamamoto H, Kano S, Tsukahara K, Okami K, Nagao T, Hanai N, Iwai H, Kawata R, Tada Y, Nibu K, Inagaki H. Prognostic impact of CRTC1/3-MAML2 fusions in salivary gland mucoepidermoid carcinoma: A multiinstitutional retrospective study. Cancer Sci 2020; 111:4195-4204. [PMID: 32860299 PMCID: PMC7648036 DOI: 10.1111/cas.14632] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is rare, but the most common primary malignancy of the salivary gland and not infrequent in young individuals. CRTC1/3-MAML2 fusions are frequently detected in MEC and are useful as a diagnostic biomarker. However, there has been debate as to whether the fusions have prognostic significance. In this study, we retrospectively collected 153 salivary gland MEC cases from 11 tertiary hospitals in Japan. As inclusion criteria, the MEC patients in this study had curative surgery as the initial treatment, received no preoperative treatment, and had no distant metastasis at the time of the initial surgery. The MEC diagnosis was validated by a central pathology review by five expert salivary gland pathologists. The CRTC1/3-MAML2 fusions were detected using FISH and RT-PCR. In 153 MEC cases, 90 (58.8%) were positive for CRTC1/3-MAML2 fusions. During the follow-up period, 28 (18.3%) patients showed tumor recurrence and 12 (7.8%) patients died. The presence of the fusions was associated with favorable tumor features. Of note, none of the fusion-positive patients died during the follow-up period. Statistical analysis showed that the presence of the fusions was a prognostic indicator of a better overall survival in the total and advanced-stage MEC cohorts, but not in the early-stage MEC cohort. In conclusion, CRTC1/3-MAML2 fusions are an excellent biomarker for favorable overall survival of patients with salivary gland MEC.
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Affiliation(s)
- Yoshihide Okumura
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
- Department of Maxillofacial SurgerySchool of DentistryAichi‐Gakuin UniversityNagoyaJapan
| | - Satsuki Nakano
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
| | - Takayuki Murase
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
| | - Kaori Ueda
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
- Department of Maxillofacial SurgerySchool of DentistryAichi‐Gakuin UniversityNagoyaJapan
| | - Daisuke Kawakita
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
| | - Toshitaka Nagao
- Department of Anatomic PathologyTokyo Medical UniversityTokyoJapan
| | | | - Makoto Urano
- Department of Diagnostic PathologySchool of MedicineFujita Health UniversityToyoakeJapan
| | - Hidetaka Yamamoto
- Department of Anatomic PathologyGraduate of School of Medical ScienceKyushu UniversityFukuokaJapan
| | - Satoshi Kano
- Department of Otolaryngology‐Head and Neck SurgeryFaculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck SurgeryTokyo Medical UniversityTokyoJapan
| | - Kenji Okami
- Department of Otolaryngology‐Head and Neck SurgeryTokai University School of MedicineIseharaJapan
| | - Toru Nagao
- Department of Maxillofacial SurgerySchool of DentistryAichi‐Gakuin UniversityNagoyaJapan
| | - Nobuhiro Hanai
- Department of Head and Neck SurgeryAichi Cancer Center HospitalNagoyaJapan
| | - Hiroshi Iwai
- Department of Otolaryngology, Head and Neck SurgeryKansai Medical UniversityHirakataJapan
| | - Ryo Kawata
- Department of Otorhinolaryngology‐Head and Neck SurgeryOsaka Medical CollegeTakatsukiJapan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and SurgeryInternational University of Health and WelfareMita HospitalTokyoJapan
| | - Ken‐Ichi Nibu
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
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Morita M, Murase T, Okumura Y, Ueda K, Sakamoto Y, Masaki A, Kawakita D, Tada Y, Nibu KI, Shibuya Y, Inagaki H. Clinicopathological significance of EGFR pathway gene mutations and CRTC1/3-MAML2 fusions in salivary gland mucoepidermoid carcinoma. Histopathology 2020; 76:1013-1022. [PMID: 32129900 DOI: 10.1111/his.14100] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/26/2022]
Abstract
AIMS Mucoepidermoid carcinoma (MEC) is one of the most common salivary gland carcinomas. Epidermal growth factor receptor (EGFR) signalling pathway gene mutations are important in predicting a patient's prognosis, selecting molecularly targeted drugs and estimating the efficacy of a molecular therapy. However, their significance in MEC have been poorly clarified. CRTC1/3-MAML2 fusions are specific to MEC and may be associated with favourable characteristics in these patients. METHODS AND RESULTS We looked for CRTC1/3-MAML2 fusions and gene alterations in the EGFR, RAS family (KRAS, HRAS and NRAS), PIK3CA, BRAF and AKT1 in 101 MEC cases. We also examined mutations in TP53. CRTC1/3-MAML2 fusions were found in 62.4% of the cases. KRAS, HRAS and PIK3CA mutations were detected in 6.9%, 2.0% and 6.9%, respectively, but other EGFR pathway genes were not mutated. In total, gene mutations (RAS/PIK3CA) in the EGFR pathway were detected in 14.9% of the cases. TP53 mutations were found in 20.8%. CRTC1/3-MAML2 fusions were associated with a better prognosis and RAS/PIK3CA mutations a worse prognosis of the patients, respectively, and both were selected as independent prognostic factors for the overall survival of the patients. TP53 mutations had no prognostic impact. CRTC1/3-MAML2 fusion-positive rates were inversely associated with the patients' age and the fusions were found in 82% of patients aged < 30 years. CONCLUSIONS RAS/PIK3CA mutations were frequently detected, and may be a biomarker for a poorer prognosis in MEC patients. CTRC1/3-MAML2 fusions were positive in most of the young MEC patients.
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Affiliation(s)
- Maki Morita
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.,Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoshihide Okumura
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Kaori Ueda
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yuma Sakamoto
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Ayako Masaki
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Daisuke Kawakita
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuyuki Shibuya
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
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Gao H, Gao Q, Sun J. Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio in Mucoepidermoid Carcinoma of Pediatrics: A Multicenter Study. Front Pediatr 2020; 8:96. [PMID: 32292769 PMCID: PMC7120218 DOI: 10.3389/fped.2020.00096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 02/24/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Our goal was to analyze the value of the pretreatment neutrophil-to-lymphocyte ratio (NLR) in the prognosis of pediatrics with parotid mucoepidermoid carcinoma (MEC). Methods: Patients (≤ 18 years old) undergoing surgical treatment for primary parotid MEC were enrolled from multiple clinical centers retrospectively. The χ2-test was used to analyze the associations between clinicopathological variables and the NLR. The main study endpoints were recurrence-free survival (RFS) and disease-specific survival (DSS). The prognostic value of NLR was assessed by Kaplan-Meier method and Cox model analysis. Results: There were 88 patients included in total, with mean NLR of 2.32 (range, 1.8-6.0). Histologic tumor grade and tumor stage were associated with the NLR significantly. The 10-year RFS rates were 98 and 81% for patients with an NLR < 2.32 and patients with an NLR ≥ 2.32, respectively, the difference was significant (p = 0.010). The 10-year DSS rate was 97 and 81% for patients with an NLR < 2.32 and patients with an NLR ≥ 2.32, respectively; the difference was not significant (p = 0.072). The independence of NLR in predicting the RFS was further confirmed in Cox model analysis. Conclusion: The NLR significantly affects the prognosis in pediatrics with primary parotid MEC.
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Affiliation(s)
- Hua Gao
- Department of Oral Medicine, Central Hospital of Yingkou, Yingkou, China
| | - Qing Gao
- Disease Control and Prevention Center, Shenyang, China
| | - Jinlan Sun
- Department of Oral Medicine, Central Hospital of Yingkou, Yingkou, China
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