Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Oct 15;113(8):2082-9.
doi: 10.1002/cncr.23825.

Treatment and survival outcomes based on histologic grading in patients with head and neck mucoepidermoid carcinoma

Melonie A Nance  1 , Raja R Seethala, Yun Wang, Simion I Chiosea, Eugene N Myers, Jonas T Johnson, Stephen Y Lai
Affiliations

Treatment and survival outcomes based on histologic grading in patients with head and neck mucoepidermoid carcinoma

Melonie A Nance et al. Cancer. .

Abstract

Background: Histopathologic grade of mucoepidermoid carcinoma (MEC) is an established predictor of prognosis and affects treatment protocol. Tumor behavior is more aggressive in high-grade than in low-grade MEC, leading to a more intensive treatment protocol. Outcomes for patients with intermediate-grade MEC are less clear; therefore, the optimal treatment protocol for this group is not well defined. The treatment protocol and survival outcomes of patients treated for MEC of the head and neck was investigated.

Methods: A retrospective clinical review and prospective review of histopathologic grading were undertaken using the most recently established grading system of 50 patients with MEC of the head and neck from 1983 through 2004.

Results: As histologic grade increased from low to intermediate to high, overall survival (P < .0001) and disease-free survival (P < .001) were significantly decreased. Overall and disease-free survival were significantly better for patients with intermediate-grade MEC than those with high-grade disease. Overall and disease-free survival were similar for patients with low-grade and intermediate-grade MEC. There was a low rate of disease recurrence in patients with intermediate-grade MEC, but this did not lead to death from disease. Although no patients with low-grade or intermediate-grade MEC died of disease, 52% of patients with high-grade MEC died of disease. Multivariate analysis revealed that histologic grade, age, and surgical margin status significantly predicted prognosis.

Conclusions: These findings suggest that, under the current histopathologic classification system, the behavior of intermediate-grade MEC is comparable to that of low-grade MEC and different from high-grade MEC, allowing for the establishment of an evidence-based treatment protocol.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Overall survival, all patients included. Kaplan-Meier curve with 95% confidence interval is indicated by dashed lines.
FIGURE 2
FIGURE 2
Disease-free survival, all patients included. Kaplan-Meier curve with 95% confidence interval is indicated by dashed lines.
FIGURE 3
FIGURE 3
Overall survival stratified by histologic grade (P<.0001, log-rank test).
FIGURE 4
FIGURE 4
Disease-free survival stratified by histologic grade (P = .0004, log-rank test).
See this image and copyright information in PMC

References

    1. Spiro RH. Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg. 1986;8:177–184. - PubMed
    1. Thompson LD. Mucoepidermoid carcinoma. Ear Nose Throat J. 2005;84:762–763. - PubMed
    1. Luna MA. Salivary mucoepidermoid carcinoma: revisited. Adv Anat Pathol. 2006;13:293–307. - PubMed
    1. Emerick KS, Fabian RL, Deschler DG. Clinical presentation, management, and outcome of high-grade mucoepidermoid carcinoma of the parotid gland. Otolaryngol Head Neck Surg. 2007;136:783–787. - PubMed
    1. Kokemueller H, Brueggemann N, Swennen G, Eckardt A. Mucoepidermoid carcinoma of the salivary glands—clinical review of 42 cases. Oral Oncol. 2005;41:3–10. - PubMed

MeSH terms