2008, Number 2
<< Back Next >>
Cir Cir 2008; 76 (2)
Prognostic factors in head and neck mucoepidermoid carcinoma
Villavicencio-Ayala B, Reséndiz-Colosia JA, Labastida-Almendaro S, Torres-Núñez MG, Peña-Torres LM, Gallegos-Hernández JF
Language: Spanish
References: 31
Page: 109-117
PDF size: 112.90 Kb.
ABSTRACT
Background: In patients with mucoepidermoid carcinoma (MEC) originating in salivary glands, because of the relative rarity of these tumors and the remarkable variability in their biological behavior, opinions differ about appropriate classification, grading, and treatment.
Objective: We undertook this study to analyze clinical and histological prognostic factors in a series of patients with MEC using univariate and multivariate survival analyses.
Methods: We reviewed 47 patients with MEC treated at our institution from 1985 to 2000. Clinical, epidemiological, treatment and follow-up data were obtained from medical records. All cases were histologically reviewed. The influence of prognostic factors on 5-and 10-year disease-specific survival was analyzed using Kaplan-Meier actuarial method and log-rank test. Cox regression tests were used to analyze the impact of the prognostic factors on survival.
Results: Females represented 59.6 %. The major salivary glands were affected in 74.5 %. Overall survival at 5 and 10 years was 78.3 % and 69.3 %, respectively. Disease-free survival at 5 years was 73.9 % and at 10 years was 67.5 %. Multivariate survival analysis revealed that tumor size (T4) (
p = 0.0008), regional metastasis (
p = 0.000), high histological grade (
p = 0.0002), perineural invasion (
p = 0.000), positive margin (
p = 0.000), necrosis (
p = 0.005), and intracystic component ‹20 % (
p = 0.0002) were correlated with a poor prognosis.
Conclusion: Clinical stage and histological grade are the main prognostic factors in mucoepidermoid carcinoma, nevertheless, our univariate and multivariate analyses showed that other clinical and histological prognostic factors are independent significant indicators.
REFERENCES
1. Pires F, Almeida O, Araujo J, Kowalsky P. Prognostic factors in head and neck mucoepidermoid carcinoma. Arch Otolaryngol Head Neck Surg 2004;130:174-180.
2. Cawson RA, Gleeson MJ, Eveson JW. The Pathology and Surgery of the Salivary Glands. Oxford: Isis Medical Media;1997. pp. 117-169.
3. Ellis GL, Auclair PL. Tumors of the salivary glands. In: Armed Forces Institute of Pathology, ed. Atlas of Tumor Pathology. Washington, DC:1996;17. pp. 155-175, 353-355.
4. Brandwein MS, Ivanov K, Wallace DI. Mucoepidermoid carcinoma: a clinicopathologic study of 80 patients with special reference to histological grading. Am J Surg Pathol 2001;25:835-845.
5. Wedell B, Burian P, Dahlenfors R. Cytogenetic observations in a mucoepidermoid carcinoma arising from heterotopic intranodal salivary gland tissue. Oncol Rep 1997;4:515-516.
6. Boahene D, Olsen K, Lewis J, Pinheiro A, Pankratz V, Bagniewsky S. Mucoepidermoid carcinoma of the parotid gland. Arch Otolaryngol Head Neck Surg 2004;130:849-856.
7. Stewart FW, Foote FW, Becker WF. Mucoepidermoid tumors of salivary glands. Ann Surg 1945;122:820-844.
8. Foote FW, Frazell EL. Tumors of major salivary glands. Cancer 1953;6:1065-1133.
9. Goode RK, Auclair PL, Ellis GL. Mucoepidermoid carcinoma of the major salivary glands. Clinical and histopathologic analysis of 234 cases with evaluation of grading criteria. Cancer 1998;82:1217-1224.
10. Jakobsson PA, Blanck C, Eneroth CM. Mucoepidermoid carcinoma of the parotid gland. Cancer 1968;22:111-124.
11. Spiro RH, Huvos AG, Berk R. Mucoepidermoid carcinoma of salivary gland origin: a clinicopathologic study of 367 cases. Am J Surg 1978;136:461-468.
12. Plambeck K, Friedrich RE, Schmelzle R. Mucoepidermoid carcinoma of salivary gland origin: classification, clinical-pathologic correlation, treatment results and long-term follow-up in 55 patients. J Craniomaxillofac Surg 1996;24:133-139.
13. AJCC Cancer Staging Manual, 6th ed. Chicago: Springer;2002.
14. Auclair PL, Goode RK, Ellis GL. Mucoepidermoid carcinoma of intraoral salivary glands. Evaluation and application of grading criteria in 143 cases. Cancer 1992;69:2021-2030.
15. Van der Wal J, Leverstein H, Snow GB. Parotid gland tumors: histologic reevaluation and reclassification of 478 cases. Head Neck 1998;20:204-207.
16. Strick MJ, Kelly C, Soames J V. Malignant tumours of the minor salivary glands¾a 20-year review. Br J Plast Surg 2004;57:624-631.
17. Locati LD, Quattrone P, Pizzin N. Primary high grade mucoepidermoid carcinoma of the minor salivary glands with cutaneous metastases at diagnosis. Oral Oncol 2002;38:401-404.
18. Nascimento AG, Amaral LP, Prado LA, Kligerman J. Mucoepidermoid carcinoma of salivary glands: a clinicopathologic study of 46 cases. Head Neck Surg 1986;8:409-417.
19. Kamio N. Coexpression of p53 and c-erbB-2 proteins is associated with histological type, tumour stage, and cell proliferation in malignant salivary gland tumours. Virchows Arch 1996;428:75-83.
20. Yin H-F, Okada N, Takagi M. Apoptosis and apoptotic-related factors in mucoepidermoid carcinoma of the oral minor salivary glands. Pathol Int 2000;50:603-609.
21. Sobral A, Loducca S, Kowalsky L, Santos S. Immunohistochemical distinction of high-grade mucoepidermoid carcinoma and epidermoid carcinoma of the parotid region. Oral Oncol 2002;38:437-440.
22. Muller S, Barnes L, Goodurn WJ Jr. Sclerosing mucoepidermoid carcinoma of the parotid. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:685-690.
23. Rodríguez-Cuevas S, Labastida S, Baena L, Gallegos-Hernández JF. Risk of nodal metastases of malignant salivary gland tumors related to tumor size and grade malignancy. Eur Arch Otorhinolaryngol 1995;252:139-142.
24. Hicks J, Flaitz C, Hawkins E. Mucoepidermoid carcinoma of salivary glands in childhood with clinical correlation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:204-207.
25. Eisele DW, Johns EM. Salivary gland neoplasms. In: Bayley JB, Harold CP, eds. Head and Neck Surgery Otolaryngology. Philadelphia: Lippincott-Raven Publisher;1996. p. 88.
26. Shieh YS, Chang LC, Chiu KC, Wu CW, Lee HS. Cadherin and catenin expression in mucoepidermoid carcinoma: correlation with histopathologic grade, clinical stage, and patient outcome. J Oral Pathol Med 2003;32:297-304.
27. Hocwald E, Korkmaz H, Adsay V. Prognostic factors in major salivary gland cancer. Laryngoscope 2001;111:1434-1439.
28. Andersen PE, Saffolds S. Management of cervical metastasis. In: Shah JP, ed. Cancer of the Head and Neck. Hamilton, BC: Decker;2001. pp. 274-287.
29. Gallegos-Hernández JF, Martínez-Gómez H, Flores-Díaz R. La disección radical de cuello en el cáncer de vías aerodigestivas superiores (VADS): indicaciones, extensión y radicalidad. Cir Ciruj 2002;70:369-376.
30. Spiro JD, Spiro RH. Salivary tumors. In: Shah JP, ed. Cancer of the Head and Neck. Hamilton, BC: Decker;2001. pp. 240-273.
31. Luna MA. Salivary mucoepidermoid carcinoma: revisited. Adv Anat Pathol 2006;13:293-307.