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Gui L, Zhu Y, Zhang Y, Tang L, Yao J. Epidemiology, prognostic factors, and treatment of head and neck mucoepidermoid carcinoma: Analysis of the surveillance, epidemiology, and end results database. Braz J Otorhinolaryngol 2024; 90:101450. [PMID: 39053162 DOI: 10.1016/j.bjorl.2024.101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/21/2024] [Accepted: 05/09/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES To investigate prognostic factors in patients with head and neck Mucoepidermoid Carcinoma (MEC), especially the impact of treatment modalities on survival. METHODS Patients with primary head and neck MEC between 2000 and 2015 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors related to Overall Survival (OS) and Cancer-Specific Survival (CSS), as well as the impact of treatments, were evaluated by multivariable Cox regression analysis. RESULTS We identified 2692 patients diagnosed with head and neck MEC, of whom 1397 (51.89%) had a parotid gland primary, 569 (22.14%) died, and 341 (12.67%) died of MEC. Older age (≥53 years), males, unmarried, lower income, tumor site in other head and neck areas, higher tumor grade, larger tumor size, and higher stage were related to poorer OS and CSS. Patients who did not undergo surgery (HR=3.20, 95% CI 2.45‒4.18) had worse OS, while no significant difference was detected between partial and total organ excision on patients' OS (p=0.729). For combination therapy, patients who received radiotherapy only (HR=3.21, 95% CI 2.27-4.53) or no surgery and no radiotherapy (HR=2.59, 95% CI 1.83-3.67) were correlated with worse OS (vs. surgery only), but no significant difference was detected between surgery only and surgery combined with radiotherapy on patients' OS (p=0.218). For CSS, the corresponding results were consistent with OS. CONCLUSION Surgical resection only may be a better survival option for head and neck MEC.
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Affiliation(s)
- Lin Gui
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Department of Medical Oncology, Beijing, China.
| | - Yiming Zhu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Department of Head and Neck Surgical Oncology, Beijing, China
| | - Ye Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Department of Radiation Oncology, Beijing, China
| | - Le Tang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Department of Medical Oncology, Beijing, China
| | - Jiarui Yao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Department of Medical Oncology, Beijing, China
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2
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Li Y, Hu C. Epidemiological and clinical characteristics of synchronous lung metastasis in major salivary gland mucoepidermoid carcinoma. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07963-5. [PMID: 37100896 DOI: 10.1007/s00405-023-07963-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVES To analyze the risk factors for synchronous lung metastases (LM) in patients with major salivary gland mucoepidermoid carcinoma (MaSG-MEC). METHODS MaSG-MEC patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2014. Descriptive statistics were used to examine the baseline characteristics of the patients. We examined the association between risk factors and synchronous LM using Chi-squared tests. The primary study outcomes were overall survival (OS) and cancer-specific survival (CSS). Kaplan-Meier survival curves were compared using the log-rank test. Hazard analysis was conducted using the Cox proportional hazards model. RESULTS A total of 701 patients were analyzed, which including 8 patients (1.1%) with synchronous LM, and 693 patients without synchronous LM (98.9%). Lower T or N classification, and highly differentiated disease were associated with a significantly lower risk of LM and multivariate logistic regression analysis showed that lower T classification were associated with a significantly lower risk of LM (P < 0.05, respectively). Elderly Caucasian male patients with poorly differentiated disease, multiple sites of metastases and no surgical therapy to primary tumor were more likely to reduce life expectancy. CONCLUSION By analyzing data from a large cohort, lower T or N classification and highly differentiated disease were associated with a significantly lower risk of LM. Elderly Caucasian male patients with poorly differentiated disease, multiple sites of metastases and no surgical therapy to primary tumor were more likely to reduce life expectancy. More accurate assessments of LM will be imperative for early diagnosis and treatment in patients who harbored with higher T or N classification and poorly differentiated disease.
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Affiliation(s)
- Yujiao Li
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201321, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, 201321, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
| | - Chaosu Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201321, China.
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, 201321, China.
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China.
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Shanghai, China.
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3
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Grasl S, Janik S, Faisal M, Grasl MC, Pammer J, Weinreb I, Fischer G, Kim J, Hosni A, de Almeida JR, Goldstein DP, Erovic BM. Influence of Grading on Management and Outcome in Mucoepidermoid Carcinoma of the Parotid-A Multi-institutional Analysis. Laryngoscope 2023; 133:124-132. [PMID: 35475580 DOI: 10.1002/lary.30135] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate clinical outcome of low (G1), intermediate (G2), and high-(G3) grade mucoepidermoid carcinomas (MEC) of the parotid gland. STUDY DESIGN Retrospective chart review including 212 patients. Clinicopathological data was statistically analyzed regarding grading, overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS). RESULTS 105 (49.5%) G1, 73 (34.5%) G2, and 34 (16%) G3 MEC were included and 56 (26.4%) patients presented with neck node metastases. The risk of occult nodal metastases was significantly associated with grading and increased from 9.2% in G1 to 26.7% and 27.8% in G2 and G3 tumors, respectively (p = 0.008). Elective periparotid and cervical lymph node dissection was performed in 170 (80.2%) and 70 (33%) patients, respectively. All patients with positive periparotid nodes when subjected to an additional neck dissection had associated cervical neck node involvement (p < 0.001). Grading was an independent significant prognostic factor for OS (HR 4.05; 95%CI: 1.15-14.35; p = 0.030) and DSS (HR 17.35; 95%CI: 1.10-273.53; p = 0.043). In a subgroup analysis, elective neck dissection (END) was also significantly associated with a better DFS (p = 0.041) in neck node-negative G1 MECs. CONCLUSION The risk of occult nodal metastasis in intermediate-grade MEC is as high as in high-grade MEC and that END in G1 tumors is associated with a prolonged DFS. Additionally, periparotid node involvement seems to be a predictor for positive neck node involvement. This study presents some preliminary data to consider END in clinically neck node negative patients with parotid MEC; however, larger series are needed. LEVEL OF EVIDENCE 3 Laryngoscope, 133:124-132, 2023.
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Affiliation(s)
- Stefan Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Muhammad Faisal
- Department of Head and Neck Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.,Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria
| | - Matthaeus C Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Johannes Pammer
- Clinical Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Gregor Fischer
- Department of Otolaryngology, Karl Landsteiner University Hospital, Krems, Austria
| | - John Kim
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria
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Mucoepidermoid Carcinoma of the Salivary Gland: Demographics and Comparative Analysis in U.S. Children and Adults with Future Perspective of Management. Cancers (Basel) 2022; 15:cancers15010250. [PMID: 36612247 PMCID: PMC9818327 DOI: 10.3390/cancers15010250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
Background: Salivary gland neoplasms are uncommon in both pediatric and adult populations. Mucoepidermoid carcinoma (MEC) is one of the most common salivary gland tumors and usually presents with atypical clinical features. This study sought to evaluate the demographic and clinical factors affecting outcomes in adults and pediatric populations with MEC that could be used to risk stratification for treatment selection and clinical trial enrollment. Methods: Data on 4507 MEC patients were extracted from the Surveillance Epidemiology and End Result (SEER) database (2000−2018). Patients aged ≤ 18 years were classified into the pediatric population, and those older than 18 years were placed in the adult group. Kaplan−Meier survival curves were created to analyze survival probabilities for various independent factors. Results: The pediatric population comprised 3.7% of the entire cohort, with a predominance of females (51.5%), while the adult population constituted 96.3% of the cohort, with a predominance of female patients (52.2%). Caucasians were the predominant race overall (75.3%), while more African Americans were seen in the pediatric group. In tumor size of <2 cm overall, poorly differentiated tumors with higher metastasis rates were observed more in adults (11.3% and 9.3%) than in the pediatric population (3.0% and 4.8%, p < 0.05). Surgical resection was the most common treatment option (53.9%), making up 63.6% of the pediatric and 53.5% of the adult groups. A combination of surgical resection and radiation was used in 29.8% of the entire cohort while a combination of surgical resection, radiation, and chemotherapy made up only 3.2%. The pediatric group had a lower overall mortality rate (5.5%) than the adult group (28.6%). Females had a higher 5-year survival rate in comparison to males (86.5%, and 73.7%, respectively). Surgical resection led to a more prolonged overall survival and 5-year cancer-specific survival (98.4% (C.I, 93.7−99.6) in the pediatric group and 88.8% (C.I, 87.5−90.0) in the adult group), respectively. Metastasis to the lung, bone, brain, and/or liver was found to have significantly lower survival rates. Multivariate analysis demonstrated that adults (hazard ratio [HR] = 7.4), Asian or Pacific Islander (HR = 0.5), male (HR = 0.8), poorly differentiated histology (HR = 3.8), undifferentiated histology (HR = 4.5), regional spread (HR = 2.1), and distant spread (HR = 3.2) were associated with increased mortality (p < 0.05). Conclusions: Mucoepidermoid carcinoma of the salivary glands primarily affects Whites and is more aggressive in adults than in the pediatric population. Even with surgical resection, the overall survival is poor in the adult population as compared to its pediatric counterparts. Advanced age, larger tumor size, male sex, and lymph node invasion are associated with increased mortality.
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5
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Taniuchi M, Kawata R, Terada T, Higashino M, Nishimura H, Kurisu Y, Kuwabara H, Hirose Y. Management and outcome of parotid mucoepidermoid carcinoma by histological grade: A 21‐year review. Laryngoscope Investig Otolaryngol 2022; 7:766-773. [PMID: 35734046 PMCID: PMC9194965 DOI: 10.1002/lio2.809] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/10/2022] [Accepted: 04/08/2022] [Indexed: 01/12/2023] Open
Abstract
Objective Mucoepidermoid carcinoma (MEC) is the most common malignancy of the parotid gland, but the outcome depends on the histological grade. Therefore, the aim of this study was to evaluate MEC on the basis of histological grade. Study Design Retrospective analysis. Methods We performed a retrospective analysis of data from patients whose initial treatment for MEC of the parotid gland was performed at our department between 1999 and 2021. We examined the association between the Armed Forces Institute of Pathology (AFIP) grade and outcome. Results The AFIP grades were as follows: low, 26 cases; intermediate, 9 cases; and high, 31 cases. About 50% of cases were correctly diagnosed as malignant, and both grade and histology were accurately determined by fine‐needle aspiration cytology in 20% of cases. The 5‐year disease‐free survival rate was 95.5% and 53.8% in the low‐/intermediate‐ and high‐grade cases, respectively. In the high‐grade group, cases with recurrence were found to have a higher rate of lymph nodes metastasis than cases without recurrence. Furthermore, in this high‐grade group, total sacrifice of the facial nerve did not reduce local recurrence. However, radical resection in the cases without tumor invasion to the nerve has decreased the local recurrence rate. The CRTC1‐MAML2 fusion gene was expressed in 42.3% of low‐/intermediate‐ and 14.3% of high‐grade cases. Conclusions The survival rate in MEC was quite different between the low‐/intermediate‐ and high‐grade cases. However, the rate of correct assessment of the grade by fine‐needle aspiration cytology was poor. In high‐grade cases, total sacrifice of the facial nerve may improve the rate of local recurrence in cases without invasion of the main trunk of the nerve. Expression of the CRTC1‐MAML2 fusion gene could be helpful in not only the assessment of grade but the prediction of recurrence. Level of Evidence 4
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Affiliation(s)
- Masataka Taniuchi
- Department of Otorhinolaryngology ‐ Head and Neck Surgery Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology ‐ Head and Neck Surgery Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology ‐ Head and Neck Surgery Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Masaaki Higashino
- Department of Otorhinolaryngology ‐ Head and Neck Surgery Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Hiromi Nishimura
- Department of Otorhinolaryngology ‐ Head and Neck Surgery Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Yoshitaka Kurisu
- Department of Pathology Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Hiroko Kuwabara
- Department of Pathology Osaka Medical and Pharmaceutical University Takatsuki Japan
| | - Yoshinobu Hirose
- Department of Pathology Osaka Medical and Pharmaceutical University Takatsuki Japan
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6
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A Huge Lesion in the Maxillary Posterior Region Diagnosed High Grade Mucoepidermoid Carcinoma of Minor Salivary Glands: A Case Report. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1017162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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7
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Gotoh S, Nakasone T, Matayoshi A, Makishi S, Hirano F, Ntege EH, Shimizu Y, Nakamura H. Mucoepidermoid carcinoma of the anterior lingual salivary gland: A rare case report. Mol Clin Oncol 2021; 16:7. [PMID: 34881027 PMCID: PMC8647187 DOI: 10.3892/mco.2021.2444] [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: 05/14/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022] Open
Abstract
Mucoepidermoid carcinomas (MECs) are rare head and neck malignant tumours that were originally considered to be benign. It has been estimated that ~20% of MECs in the major salivary glands, such as the parotid gland, and 50% in the several minor salivary glands found in the oral cavity, are malignant. The diagnosis of MECs is mainly based on ancillary and immunohistochemistry testing. However, owing to the difficulty in harvesting adequate material for histological examination, the histopathological diagnosis of intraoral MECs may be particularly challenging. We herein report a rare case of an 82-year-old patient who presented to the Department of Oral and Maxillofacial Surgery of Ryukyu University Hospital with complaints of a progressive swelling and pain in the ventral surface of the apex of the tongue. The patient had previously undergone needle biopsy and the histopathological analysis of the tumour suggested a diagnosis of irritation fibroma. To ensure a more accurate histopathological assessment, an incisional biopsy was performed, in addition to the haematological and radiological assessments. Examination of the obtained surgical specimen confirmed low-grade MEC of the anterior lingual gland. The tumour was surgically excised, the patient healed uneventfully and no recurrence was detected on the regular 3-year follow-up. Although MECs are relatively more common in the minor salivary glands of the oral cavity, they are a rare occurrence in the anterior lingual gland. Therefore, adequate histological material should be surgically harvested to perform a complete evaluation of the morphology and cytology of the tumour and ensure the accuracy of diagnosis.
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Affiliation(s)
- Shimpei Gotoh
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Shoko Makishi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Fusahiro Hirano
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Edward H Ntege
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan.,Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Yusuke Shimizu
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Hiroyuki Nakamura
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
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8
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Yan F, Lao WP, Nguyen SA, Sharma AK, Day TA. Elective neck dissection in salivary gland malignancies: Systematic review and meta-analysis. Head Neck 2021; 44:505-517. [PMID: 34862810 DOI: 10.1002/hed.26923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/25/2021] [Accepted: 10/26/2021] [Indexed: 12/27/2022] Open
Abstract
We defined the occult nodal metastasis (ONM) rate of clinical node-negative salivary gland malignancies and examined the role of elective neck dissection (END). Meta-analysis querying four databases, from inception of databases to March 25th, 2020. Fifty-one studies with 11 698 patients were included. ONM rates were 64% for salivary ductal carcinoma (SDC), 51% for undifferentiated carcinoma, 34% for carcinoma ex-pleomorphic adenoma (CXPA), 32% for adenocarcinoma not otherwise specified (ANOS), 31% for lymphoepithelial carcinoma (LE), 20% for mucoepidermoid carcinoma, 17% for acinic cell carcinoma, and 17% for adenoid cystic carcinoma. T3/T4 tumors had a 2.3 times increased risk of ONM than T1/T2 tumors. High-grade tumors had a 3.8 times increased risk of ONM than low/intermediate-grade tumors. ONM rates were exceedingly high for T3/T4, high-grade, and undifferentiated, SDC, ANOS, CXPA, and LE tumors, indicating the potential role of END.
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Affiliation(s)
- Flora Yan
- Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Wilson P Lao
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California, USA
| | - Shaun A Nguyen
- Head and Neck Tumor Center, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Anand K Sharma
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Terry A Day
- Head and Neck Tumor Center, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Isaka E, Sugiura T, Hashimoto K, Kikuta K, Anazawa U, Nomura T, Kameyama A. Characterization of tumor-associated MUC1 and its glycans expressed in mucoepidermoid carcinoma. Oncol Lett 2021; 22:702. [PMID: 34457057 PMCID: PMC8358622 DOI: 10.3892/ol.2021.12963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is one of the most frequently misdiagnosed tumors. Glycans are modulated by malignant transformation. Mucin 1 (MUC1) is a mucin whose expression is upregulated in various tumors, including MEC, and it has previously been investigated as a diagnostic and prognostic tumor marker. The present study aimed to reveal the differences in the mucin glycans between MEC and normal salivary glands (NSGs) to discover novel diagnostic markers. Soluble fractions of salivary gland homogenate prepared from three MEC salivary glands and 7 NSGs were evaluated. Mucins in MEC and NSGs were separated using supported molecular matrix electrophoresis, and stained with Alcian blue and monoclonal antibodies. The glycans of the separated mucins were analyzed by mass spectrometry. MUC1 was found in MEC but not in NSGs, and almost all glycans of MUC1 in MEC were sialylated, whereas the glycans of mucins in NSGs were less sialylated. The core 2 type glycans, (Hex)2(HexNAc)2(NeuAc)1 and (Hex)2(HexNAc)2(NeuAc)2, were found to be significantly abundant glycans of MUC1 in MEC. MEC markedly produced MUC1 modified with sialylated core 2 glycans. These data were obtained from the soluble fractions of salivary gland homogenates. These findings provide a basis for the utilization of MUC1 as a serum diagnostic marker for the preoperative diagnosis of MEC.
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Affiliation(s)
- Eisaku Isaka
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa-shi, Chiba 272-8513, Japan
| | - Takanori Sugiura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa-shi, Chiba 272-8513, Japan
| | - Kazuhiko Hashimoto
- Department of Pathology and Laboratory Medicine, Ichikawa General Hospital, Tokyo Dental College, Ichikawa-shi, Chiba 272-8513, Japan
| | - Kazutaka Kikuta
- Department of Musculoskeletal Oncology and Orthopaedic Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi 320-0834, Japan
| | - Ukei Anazawa
- Department of Orthopaedic Surgery, Tokyo Dental College, Ichikawa-shi, Chiba 272-8513, Japan
| | - Takeshi Nomura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa-shi, Chiba 272-8513, Japan.,Oral Cancer Center, Tokyo Dental College, Ichikawa-shi, Chiba 272-8513, Japan
| | - Akihiko Kameyama
- Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8565, Japan
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10
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Dahan LS, Giorgi R, Vergez S, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Garrel R, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Moya-Plana A, Even C, Radulesco T, Michel J, Baujat B, Fakhry N, Albert S, Andry G, Babin E, Bach C, Badet JM, Badoual C, Baglin A, Banal A, Barry B, Baudin E, Baujat B, Bensadoun R, Bertolus C, Bessède JP, Blanchard D, Borel C, Bozorg-Grayeli A, Breheret R, Breton P, Brugel L, Calais G, Casiraghi O, Cassagnau E, Castillo L, Ceruse P, Chabolle F, Chevalier D, Chobaut J, Choussy O, Cosmidis A, Coste A, Costes V, Crampette L, Darrouzet V, Demez P, Dessi P, Devauchelle B, Dolivet G, Dubrulle F, Duflo S, Dufour X, Faivre S, Fakhry N, Ferron C, Floret F, de Gabory L, Garrel R, Geoffrois L, Gilain L, Giovanni A, Girod A, Guerrier B, Hans S, Herman P, Hofman P, Housset M, Jankowski R, Jegoux F, Juliéron M, Kaminsky MC, Kolb F, St Guily JL, Laccoureye L, Lallemant B, Lang P, Lartigau E, Lavieille JP, Lefevre M, Leroy X, Malard O, Massip F, Mauvais O, Merol JC, Michel J, Mom T, Morinière S, de Monès E, Moulin G, Noel G, Poissonnet G, Prades JM, Radulesco T, de Raucourt D, Reyt E, Righini C, Robin YM, Rolland F, Ruhin B, Sarroul N, Schultz P, Serrano E, Sterkers O, Strunski V, Sudaka A, Tassart M, Testelin S, Thariat J, Timochenko A, Toussaint B, Coste EU, Valette G, Van den Abbeele T, Varoquaux A, Veillon F, Vergez S, Wassef M. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 2021; 47:1376-1383. [DOI: 10.1016/j.ejso.2020.11.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/31/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
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Hendawy H, Esmail AD, Zahani AMN, Elmahdi AH, Ibrahiem A. Clinicopathological correlation of stem cell markers expression in oral squamous cell carcinoma; relation to patients` outcome. J Immunoassay Immunochem 2021; 42:571-595. [PMID: 33896397 DOI: 10.1080/15321819.2021.1911814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Squamous cell carcinoma (OSCC) is the commonest oral malignancy.The overall 5 year survival of OSCC has remained at 50%, largely unchanged for 40 years. CSCs are important within the development, invasion, drug resistance, and prediction of carcinomas treatment outcome. ALDH1 and CD44 are commonly used epithelial tumors cancer stem-like cells surface markers. Materials: Our study aimed to judge CD44 and ALDH1 immunohistochemical expressions in 44 cases of OSCC and relates the expression to patients' survival. Results: High CD44 & ALDH1 expressions were significantly expressed in variable histologic grades of OSCCs, large sized carcinomas, presence lymph vascular invasion, presence of nodal and distant metastasis, advanced TNM clinical stage, recurrence and death during follow up period (P ≤ 0.05). Reduced DFS and three years overall survival were significantly recorded in cases with high CD44 expression, and high ALDH1 expression (p < 0.05). CD44 & ALDH1 expressions, histologic grade, tumor size were the independent predictors of DFS and three years OS. Conclusion: CD44 and ALDH1 expressions are valuable prognostic factors in OSCC and could be well considered predictors for patients' 3 years OS and DFS.
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Affiliation(s)
- Heba Hendawy
- Lecturer of Oral and Maxillofacial Pathology, Mansoura University Faculty of Dentistry, Mansoura, Egypt
| | - A Doaa Esmail
- Lecturer of Oral and Maxillofacial Pathology, Mansoura University Faculty of Dentistry, Mansoura, Egypt
| | - A M Nashwa Zahani
- Teaching Assistant, Northern Border University Faculty of Medicine, Arar, Saudi Arabia
| | - Al Hoda Elmahdi
- Lecturer of Oral and Maxillofacial Pathology, Mansoura University Faculty of Dentistry, Mansoura, Egypt
| | - Afaf Ibrahiem
- Lecturer of Oral and Maxillofacial Pathology, Mansoura University Faculty of Dentistry, Mansoura, Egypt.,Lecturer of pathology, Faculty medicine, Mansoura University , Egypt
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12
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Taylor ZC, Kaya EA, Bunn JD, Guss ZD, Mitchell BJ, Fairbanks RK, Lamoreaux WT, Wagner AE, Peressini BJ, Lee CM. Overall and cause-specific survival for mucoepidermoid carcinoma of the major salivary glands: Analysis of 2210 patients. World J Clin Oncol 2020; 11:1029-1044. [PMID: 33437665 PMCID: PMC7769719 DOI: 10.5306/wjco.v11.i12.1029] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/05/2020] [Accepted: 11/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mucoepidermoid carcinoma (MEC) is a rare malignancy of the head and neck; however, it accounts for a majority of the tumors of the salivary glands. This study used a national population-based registry to describe the pre-treatment and treatment-related prognostic factors that influence survival in patients with MEC of the major salivary glands. To our knowledge, this is the largest population-based study examining predictors of both overall and cause-specific survival of MEC of the major salivary glands.
AIM To identify prognostic factors influencing overall survival (OS) and cause-specific survival (CSS) of patients with MEC of the major salivary glands.
METHODS We used the Surveillance, Epidemiology and End-Results Database of the National Cancer Institute to investigate a variety of factors that could influence survival of patients diagnosed with mucoepidermoid carcinoma of the major salivary glands. A total of 2210 patients diagnosed with MEC of the major salivary glands during the years of 1975-2016 were studied. The primary endpoints were OS and CSS. Cox regression analysis was used to perform univariate and multivariate analyses of clinical variables such as age at diagnosis, diagnosis year, sex, race, tumor size, stage, grade, treatment with or without surgical excision, and adjuvant radiotherapy treatment.
RESULTS A total of 2210 patients diagnosed with MEC of the major salivary glands met inclusion criteria. In this study, 95% of patients underwent surgical excision and 41% received adjuvant radiation therapy. Median OS time for Grade I, II, and III/IV was 401 mo (± 48.25, 95%CI), 340 mo (± 33.68, 95%CI) and 55 mo (± 11.05, 95%CI), respectively. Univariate analysis revealed that lack of surgical excision was associated with decreased OS [hazard ratio (HR) 4.26, P < 0.0001] and that patients with localized disease had improved OS compared to both regional and distant disease (HR 3.07 and 6.96, respectively, P < 0.0001). Additionally, univariate analysis demonstrated that male sex, age over 50 at diagnosis, Grade III tumors, and increasing tumor size were associated with worsened OS (P < 0.0006). Univariate analysis of CSS similarly revealed that lack of surgical excision and Grade III carcinoma conferred decreased CSS (HR 4.37 and 5.44, respectively, P < 0.0001). Multivariate analysis confirmed that increasing age, in 10-year age bands, advanced tumor stage, increasing tumor size, Grade III carcinoma, male sex, and lack of surgical excision were associated with a statistically significant decrease in OS and CSS (P < 0.04). Of note, multivariate analysis revealed that the use of adjuvant radiation therapy was not associated with improved OS or CSS.
CONCLUSION Multivariate analysis demonstrated increasing age, advanced tumor stage, increasing tumor size, Grade III carcinoma, male sex, and lack of surgical excision were associated with decreased OS and CSS (P < 0.04).
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Affiliation(s)
- Zachary C Taylor
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
- MD Program, Elson S. Floyd College of Medicine, Spokane, WA 99202, United States
| | - Erin A Kaya
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
- MD Program, Elson S. Floyd College of Medicine, Spokane, WA 99202, United States
| | - Jeffrey D Bunn
- Surgery, Spokane Ear, Nose, and Throat, Spokane, WA 99201, United States
| | - Zachary D Guss
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
| | - Brian J Mitchell
- Surgery, Spokane Ear, Nose, and Throat, Spokane, WA 99201, United States
| | - Robert K Fairbanks
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
| | - Wayne T Lamoreaux
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
| | - Aaron E Wagner
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
| | - Ben J Peressini
- Department of Biostatistics, DataWorks Northwest, LLC, Coeur D'Alene, ID 83815, United States
| | - Christopher M Lee
- Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA 99202, United States
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13
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Peraza A, Gómez R, Beltran J, Amarista F. Mucoepidermoid carcinoma. An update and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:713-720. [DOI: 10.1016/j.jormas.2020.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
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14
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Terauchi M, Michi Y, Hirai H, Sugiyama K, Wada A, Harada H, Yoda T. Prognostic factors in mucoepidermoid carcinoma of the minor salivary glands: A single-center retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:209-216. [PMID: 33187937 DOI: 10.1016/j.oooo.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/20/2020] [Accepted: 10/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the prognostic effects of clinical and histologic findings in patients with mucoepidermoid carcinoma (MEC) of minor salivary glands. STUDY DESIGN This retrospective clinical review included 63 patients (30 males, mean age 52.8 years) with minor salivary gland MEC treated at our hospital from 1994 to 2019. Overall survival (OS) or disease-free survival was determined using the Kaplan-Meier limit method. Correlations between different factors and survival rates were assessed using chi-square tests. RESULTS The 10-year OS rate was 91.2%. Low- or intermediate-grade MEC had a good prognosis regardless of the surgical margin, whereas high-grade MEC had a poor 10-year OS rate (64.2%). Ten patients developed recurrence or metastasis after primary surgical resection, of whom 6 were diagnosed with a high-grade tumor. The most frequently affected site was the palate, whereas the mandibular gingiva was the most commonly affected site during recurrence. Of 4 patients who received chemotherapy and/or radiotherapy postsurgery, 2 had local recurrence and/or neck lymph node metastasis and 1 died from MEC. CONCLUSION Patients with low- or intermediate-grade MEC exhibited satisfactory survival after surgery. In patients with high-grade tumors, it has been suggested that survival rates are poor and do not improve following adjuvant therapy.
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Affiliation(s)
- Masahiko Terauchi
- Project Assistant Professor, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuyuki Michi
- Junior Associate Professor, Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Hideaki Hirai
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kentaro Sugiyama
- Clinical Fellow, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akane Wada
- Clinical Fellow, Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Professor, Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Yoda
- Professor, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
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15
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Reny DC, Ranasinghe VJ, Magana LC, Kaufman AC, Chalian AA, O'Malley BW, Weinstein GS, Brody RM. Predictors of Nodal Metastasis in Mucoepidermoid Carcinoma of the Oral Cavity and Oropharynx. ORL J Otorhinolaryngol Relat Spec 2020; 82:327-334. [PMID: 32810854 DOI: 10.1159/000509142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 06/03/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Mucoepidermoid carcinoma (MEC) of the upper aerodigestive tract (UADT) is an uncommon malignancy, with limited literature available on its clinical and pathologic characteristics. Here, we describe the behavior of MEC of the UADT including pathologic characteristics and predictors of nodal metastasis. METHODS Retrospective cohort study of patients with MEC of the UADT treated at an academic medical center from January 2008 to May 2018. Data was collected about demographics and tumor characteristics including clinical and histological data. The two-tailed Student t test and χ2 analysis were performed to assess for predictors of nodal metastasis. RESULTS We identified 44 patients with minor salivary gland MEC of the oral cavity (OC) and oropharynx (OP). All patients were treated with primary site surgery. The primary site was the OC in 25 patients (57%) and OP in 19 (43%). Low-grade histology was seen in 27 specimens (61.4%), intermediate histology in 9 specimens (20.5%), and high-grade histology in 8 specimens (18.2%). Perineural invasion was noted in 10 specimens (22.7%). Neck dissection was performed in 17 patients (39%), with pathologically positive nodes found in 9 (20.5%). Notably, 5 of the 9 positive nodal specimens were found in clinically node-negative necks. Pathologically positive cervical lymph nodes were significantly associated with the OP as the primary site (p = 0.0005), perineural invasion (p = 0.012), lymphovascular invasion (p < 0.001), and high-grade histology (p = 0.004) in the primary specimen. DISCUSSION MEC of the UADT is an uncommon malignancy. Our findings suggest elective neck dissection should be considered with perineural and lymphovascular invasion, high-grade tumor, and the OP as the primary site.
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Affiliation(s)
- Danielle C Reny
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Viran J Ranasinghe
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Linda C Magana
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adam C Kaufman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ara A Chalian
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bert W O'Malley
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gregory S Weinstein
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert M Brody
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,
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16
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Prognosis of Pediatric Patients With Mucoepidermoid Carcinoma of the Parotid Gland. J Craniofac Surg 2019; 31:e123-e126. [PMID: 31764567 DOI: 10.1097/scs.0000000000006048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To summarize the prognosis of pediatric patients with mucoepidermoid carcinoma (MEC) of the parotid gland. METHODS Pediatric patients with MEC of parotid gland who were surgically treated at the Capital Medical University School of Stomatology from 2000 to 2014 were retrospectively analyzed. Clinical characteristics, pathology reports, and operation records were reviewed and analyzed. RESULTS In total, 33 patients with an average age of 13.2 years were enrolled. The 5-year overall survival and disease-free survival were 95.8% and 84.4%, respectively. The disease-free survival and overall survival rates were lower in the under-10 age group (75.0 versus 87.7% and 83.3% versus 100%), though no statistically significant difference was found (P = 0.279 and P = 0.075). The patients who underwent complete resection all had a good prognosis without any recurrence or death regardless of whether the cut margin was 1.0 cm, 0.5 cm, or only extracapsular. One patient experienced 3 recurrences within 18 months and eventually died of disease. CONCLUSION Good outcomes were achieved in pediatric patients with MEC of the parotid gland. Radical resection ensured a good prognosis regardless of the extent of resection. Frequent recurrence in a short period was associated with a poor prognosis. TRIAL REGISTRATION None.
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17
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Sun J, Sun Y, Yang F, Zhou Q, Liu W, Cheng Y, Wu X, Chen T, Li R, Huang B, Att W, Yu Y, Bi W. Nomogram to predict the prognosis of parotid gland mucoepidermoid carcinoma: a population-based study of 1306 cases. PeerJ 2019; 7:e7237. [PMID: 31304070 PMCID: PMC6610557 DOI: 10.7717/peerj.7237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/03/2019] [Indexed: 11/20/2022] Open
Abstract
Background Mucoepidermoid carcinoma (MEC) is a common cancer in the oral salivary gland malignancy, which mainly occurs in the parotid gland. The aim of this study is to identify independent prognostic factors and establish a nomogram model for parotid gland mucoepidermoid carcinoma (P-MEC) patients using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. Method Patients with P-MEC were selected from between 2004 and 2015. The overall survival (OS) and cancer-specific survival (CSS) rates were estimated using the Kaplan-Meier method with the log-rank test. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify the independent prognostic factors. Results A total of 1,306 patients with P-MEC were enrolled. Age, grade, T stage, N stage, M stage, chemotherapy, and surgery type were independent prognostic factors for OS and CSS. A nomogram for OS was formulated based on these independent prognostic factors and validated using an internal bootstrap resampling approach, which showed that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.877, 95% CI [0.855–0.898]). Conclusion Several prognostic factors for P-MEC were identified. The nomogram developed in this study accurately predicted the 5- and 10-year OS rates of American patients with P-MEC based on individual characteristics. Risk stratification using the survival nomogram can optimize individual therapies and follow-up.
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Affiliation(s)
- Jian Sun
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Sun
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Fei Yang
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qianrong Zhou
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wenjuan Liu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of Stomatology, Xuhui Central Hospital, Shanghai, China
| | - Yong Cheng
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xingwen Wu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tinglan Chen
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ruixue Li
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Borui Huang
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wael Att
- Department of Prosthodontics, School of Dentistry, Albert Ludwigs University, Freiburg, Germany.,Department of Prosthodontics, Dental Medicine, Tufts University School, Boston, United States of America
| | - Youcheng Yu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Bi
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
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18
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Zenga J, Yu Z, Parikh A, Chen JX, Lin DT, Emerick KS, Faquin WC, Varvares MA, Deschler DG. Mucoepidermoid Carcinoma of the Parotid: Very Close Margins and Adjuvant Radiotherapy. ORL J Otorhinolaryngol Relat Spec 2019; 81:55-62. [PMID: 30939481 DOI: 10.1159/000497438] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND/AIMS The importance of adjuvant radiotherapy in patients with close margin resections for mucoepidermoid carcinoma of the parotid gland remains unclear. METHODS Patients who underwent parotidectomy for mucoepidermoid carcinoma with or without adjuvant radiotherapy at a single academic tertiary care center from 2000 to 2014 were identified. Included patients had negative but close (≤2 mm) surgical margins without other high-risk histopathological factors including advanced T-stage, positive nodal disease, lymphovascular or perineural invasion, or high-grade histology. RESULTS Nineteen patients were identified, of whom 15 (79%) were observed postoperatively, while 4 (21%) underwent adjuvant radiotherapy. There were no significant differences in extent of parotidectomy, elective neck dissection, T staging, or tumor size between patients who were observed and those undergoing adjuvant radiation. There were no locoregional or distant recurrences in any patients at a mean follow up 74.3 months. Patients undergoing adjuvant radiation, however, had significantly more intermediate-grade as compared to low-grade histology (75% vs. 13%, difference 62%, 95% CI 4% to 100%). CONCLUSIONS Patients with negative but close (≤2 mm) surgical margins without other high-risk histopathological factors have excellent long-term locoregional control with surgery alone. The effects of adjuvant radiotherapy for those who have intermediate-grade disease remain uncertain.
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Affiliation(s)
- Joseph Zenga
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Zizi Yu
- Harvard Medical School, Boston, Massachusetts, USA
| | - Anuraag Parikh
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Jenny X Chen
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Derrick T Lin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Kevin S Emerick
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - William C Faquin
- Department of Pathology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark A Varvares
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Daniel G Deschler
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA,
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Qian K, Sun W, Guo K, Zheng X, Sun T, Chen L, Xiang J, Li D, Wu Y, Ji Q, Wang Z. The number and ratio of positive lymph nodes are independent prognostic factors for patients with major salivary gland cancer: Results from the surveillance, epidemiology, and End Results dataset. Eur J Surg Oncol 2018; 45:1025-1032. [PMID: 30472214 DOI: 10.1016/j.ejso.2018.11.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/09/2018] [Accepted: 11/12/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION To investigate whether the positive lymph node number (PLNN) and positive lymph node ratio (PLNR) could predict the prognosis of patients with major salivary gland cancer (MSGC) and to identify the optimal cutoff points for these variables that stratify patients according to their risk of survival. METHODS We used the Surveillance, Epidemiology, and End Results (SEER) database to identify all patients with MSGC between 1988 and 2014. A logistic regression analysis was carried out to evaluate the risk factors for lymph node metastasis (LNM) in MSGC. The X-tile program was used to identify the cutoff values for the PLNN and PLNR in MSGC patients with LNM. Cox proportional hazards regression models were performed to identify the predictors of cancer-specific survival (CSS). RESULTS In the SEER database, 8668 eligible patients were identified and 3046 of them had LNM. The logistic regression analysis indicated that older age, male sex, larger tumor size, higher grade, tumor extension and high-risk pathology were associated with LNM. The X-tile program showed that a PLNN>4 and a PLNR>0.15 were prognostic indicators of CSS. A multivariable analysis indicated that, after the factors that might potentially affect the prognosis were adjusted for, the PLNN and PLNR were still associated with CSS. CONCLUSIONS Our Results demonstrated that the PLNN and PLNR were independent prognostic indicators for MSGC patients with lymph node metastasis.
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Affiliation(s)
- Kai Qian
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wenyu Sun
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Kai Guo
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiaoke Zheng
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Tuanqi Sun
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Lili Chen
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jun Xiang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Duanshu Li
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yi Wu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qinghai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhuoying Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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20
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Rajasekaran K, Stubbs V, Chen J, Yalamanchi P, Cannady S, Brant J, Newman J. Mucoepidermoid carcinoma of the parotid gland: A National Cancer Database study. Am J Otolaryngol 2018; 39:321-326. [PMID: 29559174 DOI: 10.1016/j.amjoto.2018.03.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/11/2018] [Accepted: 03/13/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To describe the demographics, tumor characteristics, and prognostic features of mucoepidermoid carcinoma of the parotid gland. MATERIALS AND METHODS A retrospective study of the National Cancer Database was reviewed for all mucoepidermoid carcinomas of the parotid gland between 2004 and 2012). Patient demographics and tumor characteristics were abstracted and analyzed. Univariate and multivariate Cox multivariate regression models were used to identify predictors of survival. RESULTS A total of 4431 patients met inclusion criteria. Average age at diagnosis was 57 years (median 62, SD 19), with no overall sex preference (52% female), and majority white (78%). The 1-year overall survival was 92.9% (95% CI [92.1-93.6]) and 5-year overall survival was 75.2% (95% CI [73.8-76.7%]). Median overall survival was not reached at 5 years. Factors associated with decreased survival were increasing age, comorbidities, high tumor grade, advanced pathologic group stage, and positive surgical margins. Female sex was the only factor associated with improved survival. Controlling for either histopathologic grade or pathologic stage to determine how patient demographics and tumor characteristics affected overall survival yielded similar results. Of note, intermediate grade tumors, although not independently associated with worse survival, when seen in conjunction with tumors ≥T2 and/or ≥N2, a negative impact on overall survival was seen. CONCLUSION Although mucoepidermoid carcinoma of the parotid gland is the most common parotid gland malignancy, it is still a rare tumor with a lack of large population-based studies. Advanced stage and high-grade tumors are significant predictors of decreased survival. Females have improved survival compared to males.
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Affiliation(s)
- Karthik Rajasekaran
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States.
| | - Vanessa Stubbs
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Jinbo Chen
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, United States
| | - Pratyusha Yalamanchi
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Steven Cannady
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Jason Brant
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Jason Newman
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
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Qian K, Di L, Guo K, Zheng X, Ji Q, Wang Z. Cervical Lymph Node Metastatic Status and Adjuvant Therapy Predict the Prognosis of Salivary Duct Carcinoma. J Oral Maxillofac Surg 2018; 76:1578-1586. [PMID: 29544756 DOI: 10.1016/j.joms.2018.01.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/08/2018] [Accepted: 01/29/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Salivary duct carcinoma (SDC) is an aggressive malignancy that is not yet fully understood. We designed the present retrospective study to investigate the factors affecting the prognosis of SDC and the effects of adjuvant therapies on the clinical outcomes of patients. MATERIALS AND METHODS Patients with SDC treated surgically from 2006 to 2016 were enrolled in the present retrospective cohort study. The demographic data, clinical pathologic characteristics, and follow-up results were recorded. The prognostic indicators of overall survival (OS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS) were analyzed using the Kaplan-Meier method and the Cox proportional hazard model. RESULTS The study sample included 66 patients, most of whom were male (81.8%). The 5-year OS, LRFFS, and DMFS for all patients was 52.5%, 63.9%, and 51.3%, respectively. Univariate analysis showed that stage N2-N3, lymph node involvement of levels IV and V, 8 or more positive lymph nodes, and extranodal extension were all negative prognostic indicators for OS. The only significant indicator on multivariate analysis was the number of positive lymph nodes. Multivariate analysis revealed that extracapsular invasion and no adjuvant radiotherapy were risk factors for LRFFS. In contrast, lesions involving both glands and 8 or more positive lymph nodes were prognostic factors for DMFS. Further subgroup analysis showed that radiotherapy was only useful for patients with locally advanced lesions for local control. CONCLUSIONS Cervical lymph node metastatic status is an important factor in predicting the prognosis of SDC patients. Adjuvant radiotherapy is useful for local control, especially for patients with stage T4 disease but does not benefit OS and DMFS.
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Affiliation(s)
- Kai Qian
- Resident, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lu Di
- Resident, Departments of Oncology and Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kai Guo
- Resident, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoke Zheng
- Resident, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qinghai Ji
- Professor, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuoying Wang
- Professor, Departments of Head and Neck Surgery and Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
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22
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Wang X, Luo Y, Li M, Yan H, Sun M, Fan T. Management of salivary gland carcinomas - a review. Oncotarget 2018; 8:3946-3956. [PMID: 27992367 PMCID: PMC5354805 DOI: 10.18632/oncotarget.13952] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 12/08/2016] [Indexed: 11/29/2022] Open
Abstract
Salivary gland carcinomas are a heterogeneous group of tumors with many histological subtypes which occur in both major and minor salivary glands. However, they have a relatively low of incidence. Their rarity limits study size and the ability to perform phase III trials. Therefore, to date, the entire management is usually varied. Certain published studies have paid more attention to the systemic therapy in the management of metastatic or locally recurrent salivary gland cancer, while little effort has been made to study the entire management for this lesions. Although results of treatment for patients with salivary gland carcinoma have improved in recent years, the treatment of salivary gland cancers is still not standardized. And some patients who haven’t received optimal treatment strategies had a reduced survival. In this review, the topics covered include surgery and radiotherapy, selective neck dissection, chemotherapy, and targeted therapy, which aimed to summarize the optimal management approaches and to develop recommendations for managing this lesions. For these rare cancers, there is also a need for a determined, coordinated effort to conduct high-quality clinical trials.
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Affiliation(s)
- Xiaoli Wang
- School of Medical and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Yijun Luo
- School of Medical and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Hongjiang Yan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Mingping Sun
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Tingyong Fan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
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23
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Janet-Ofelia GC, Rafael MV, Guillermo GA, Carlos-Enrique CV, José-Martín RM, Henry GM, Jaime-Enrique MG. Mucoepidermoid Carcinoma of the Salivary Glands: Survival and Prognostic Factors. J Maxillofac Oral Surg 2017; 16:431-437. [PMID: 29038625 PMCID: PMC5628063 DOI: 10.1007/s12663-016-0946-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 07/21/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to establish global survival rates and potential prognostic factors for mucoepidermoid carcinoma (MC) of the salivary glands in patients diagnosed at the Dr. Eduardo Cáceres Graziani National Institute for Neoplastic Diseases (INEN), Lima, Peru, between 2002 and 2012. MATERIALS AND METHODS This was an observational, analytical and longitudinal (information reconstructed in time) retrospective cohort study. Data were obtained from clinical records and used to determine the overall survival (OS) rate at 2 and 5 years, and the individual percentage survival for each prognostic factor using the actuarial technique. We also performed univariate analysis for each possible prognostic factor using log-rank analysis, and multivariate analysis using Cox's regression model. The study was approved by the institutional review board at Dr. Eduardo Caceres Graziani INEN and conducted in accordance with the 1964 Declaration of Helsinki. For this type of study formal consent was not required. RESULTS The OS rate of the 51 patients enrolled in the study was 81 % at 2 years and 78 % at 5 years. In the multivariate analysis, the equation that best explained the survival result contained the variable, clinical stage (p = 0.063). CONCLUSIONS The results revealed the importance of clinical stage regarding the survival of patients with a primary diagnosis of MC of the salivary glands.
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24
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Margin Analysis: Malignant Salivary Gland Neoplasms of the Head and Neck. Oral Maxillofac Surg Clin North Am 2017; 29:315-324. [PMID: 28551337 DOI: 10.1016/j.coms.2017.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There are no established protocols for the optimum surgical margin required for salivary gland malignancies. Factors including histologic diagnosis and TNM stage have been shown to be important in prognosis and survival outcome and mandate special consideration of margin size. Salivary cancers are treated differently at different anatomic sites, and different histologic types show a propensity for major or minor glands. Low-grade malignancies are treated with soft tissue margins of 1 cm or less. The facial nerve is preserved unless infiltrated and encased. Adenoid cystic carcinoma and carcinoma ex pleomorphic adenoma require more complex planning to obtain negative margins.
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25
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Xu W, Wang Y, Qi X, Xie J, Wei Z, Yin X, Wang Z, Meng J, Han W. Prognostic factors of palatal mucoepidermoid carcinoma: a retrospective analysis based on a double-center study. Sci Rep 2017; 7:43907. [PMID: 28262804 PMCID: PMC5338264 DOI: 10.1038/srep43907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/31/2017] [Indexed: 12/20/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) of the palate is a common malignancy of minor salivary glands. This study was designed to identify the prognostic factors for MEC of the palate. The medical records of patients diagnosed with MEC of the palate who visited the Department of Oral and Maxillofacial Surgery at Nanjing Stomatological Hospital and the Department of Stomatology at Central Hospital of Xuzhou were retrospectively studied. The prognostic factors were determined using a Cox proportional hazards model. Furthermore, the expression of cancer stem cell (CSC) markers CD44, CD133, Nanog and Sox2 were detected in neoplastic samples of these patients by immunohistochemistry. As a result, both univariate analysis and multivariate analysis proved a high histological grade and an advanced tumor stage as negative prognostic factors for overall survival. By immunohistochemistry staining and survival analysis, a combination of CD44/CD133/SOX2 was found to have the strongest prognostic value for palatal MEC patients. In conclusion, the proposed nomogram which include histological grade and tumor stage along with cancer stem cell markers provides a more accurate long-term prediction for palatal MEC patients.
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Affiliation(s)
- Wenguang Xu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Yufeng Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Xiaofeng Qi
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Junqi Xie
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Zheng Wei
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Xiteng Yin
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Zhiyong Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
| | - Jian Meng
- Department of Stomatology, Xuzhou Central Hospital, Affiliated Hospital of Medical College of Southeast University, Xuzhou 221009, People’s Republic of China
| | - Wei Han
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, P.R. China
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26
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Mochizuki D, Adams A, Warner KA, Zhang Z, Pearson AT, Misawa K, McLean SA, Wolf GT, Nör JE. Anti-tumor effect of inhibition of IL-6 signaling in mucoepidermoid carcinoma. Oncotarget 2015; 6:22822-35. [PMID: 26287605 PMCID: PMC4673202 DOI: 10.18632/oncotarget.4477] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 05/30/2015] [Indexed: 12/31/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is the most frequent malignant salivary gland cancer. Response to chemoradiotherapy is modest, and therefore radical surgery remains the standard-of-care. Emerging evidence suggests that Interleukin (IL)-6 signaling correlates with the survival of cancer stem cells and resistance to therapy. Here, we investigated whether inhibition of IL-6 receptor (IL-6R) signaling with tocilizumab (humanized anti-human IL-6R antibody) sensitizes MEC to chemotherapy using human mucoepidermoid carcinoma cell lines (UM-HMC) and correspondent xenograft models. In vitro, we observed that tocilizumab inhibited STAT3 phosphorylation but had no measurable effect in MEC cell viability (UM-HMC-1,-3A,-3B). In contrast, the anti-tumor effect of single agent tocilizumab on MEC xenografts was comparable to paclitaxel or cisplatin. Combination of tocilizumab with cisplatin or paclitaxel enhanced the inhibitory effect of chemotherapy on xenograft growth (P < 0.05), time to failure (P < 0.01), decreased vascular endothelial growth factor (VEGF) expression and tumor microvessel density (P < 0.05) without added systemic toxicities. Notably, tocilizumab decreased the fraction of MEC cancer stem cells (ALDH(high)CD44(high)) in vitro, and prevented paclitaxel-induced increase in the fraction of cancer stem cells in vivo (P < 0.05). Collectively, these findings demonstrate that tocilizumab enhances the anti-tumor effect of conventional chemotherapy in preclinical models of mucoepidermoid carcinoma, and suggest that patients might benefit from combination therapy with an inhibitor of IL-6R signaling and chemotherapeutic agent such as paclitaxel.
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Affiliation(s)
- Daiki Mochizuki
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Otolaryngology/Head Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - April Adams
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Kristy A. Warner
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Zhaocheng Zhang
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Alexander T. Pearson
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Kiyoshi Misawa
- Department of Otolaryngology/Head Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Scott A. McLean
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Gregory T. Wolf
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Jacques E. Nör
- Department of Restorative Sciences, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Otolaryngology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Biomedical Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan, USA
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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27
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Myoepithelial Carcinoma of the Nasopharynx: Report of a Rare Case and a Review of the Literature. Head Neck Pathol 2015; 9:474-80. [PMID: 26115759 PMCID: PMC4651929 DOI: 10.1007/s12105-015-0638-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 06/20/2015] [Indexed: 12/26/2022]
Abstract
Salivary gland carcinomas are very rare in the nasopharynx, with the most frequent histologic types being adenoid cystic carcinoma, mucoepidermoid carcinoma and adenocarcinoma, not otherwise specified. Myoepithelial carcinoma (MECA) is a rare tumor of the salivary glands, and there are only three previously reported cases of nasopharyngeal MECA. The case presented is the fourth reported case of MECA in the nasopharynx. Due to the morphologic heterogeneity of MECA, immunohistochemistry is indispensable in ascertaining the diagnosis. MECA is a locally aggressive tumor, but the long-term prognosis of this tumor in the nasopharynx remains uncertain. In our case the tumor was unresectable and the patient was given chemo-radiotherapy. Despite this, residual tumor was seen on nasoscopy 5 months after initial diagnosis and was documented on a re-biopsy which displayed the same histomorphologic features as the original tumor.
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28
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Liu S, Ruan M, Li S, Wang L, Yang W. Increased expression of MUC1 predicts poor survival in salivary gland mucoepidermoid carcinoma. J Craniomaxillofac Surg 2014; 42:1891-6. [DOI: 10.1016/j.jcms.2014.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/05/2014] [Accepted: 07/28/2014] [Indexed: 02/03/2023] Open
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29
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Sepúlveda I, Frelinghuysen M, Platin E, Spencer ML, Compan A, Munzenmayer J, Ulloa D. Mandibular central mucoepidermoid carcinoma: a case report and review of the literature. Case Rep Oncol 2014; 7:732-8. [PMID: 25493087 PMCID: PMC4256002 DOI: 10.1159/000368825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report the case of a patient whose main complaint was swelling on the right side of the mandible when he presented to the Ear, Nose and Throat (ENT) Service. Imaging studies revealed a large homogeneous, multilocular, expansive lesion in the body of the right mandibular ramus. The lesion was poorly enhanced following intravenous contrast injection. The patient was treated with hemimandibular surgical resection, fibula free flap reconstruction and adjuvant radiotherapy. Currently, the patient is disease free and free of posttreatment complications.
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Affiliation(s)
- Ilson Sepúlveda
- ENT-Head and Neck Surgery Service, General Hospital of Concepción, Santiago, Chile ; Finis Terrae University, School of Dentistry, Santiago, Chile
| | - Michael Frelinghuysen
- Radiotherapy Unit of Oncology Service, General Hospital of Concepción, Santiago, Chile
| | - Enrique Platin
- Department of Oral and Maxillofacial Radiology, University of North Carolina School of Dentistry, Chapel Hill, N.C., USA
| | - M Loreto Spencer
- Pathology Department, General Hospital of Concepción, Santiago, Chile
| | - Alvaro Compan
- ENT-Head and Neck Surgery Service, General Hospital of Concepción, Santiago, Chile
| | | | - David Ulloa
- Private Practice, Concepción, School of Dentistry, Santiago, Chile
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