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. 2022 Jun:20:101410.
doi: 10.1016/j.tranon.2022.101410. Epub 2022 Apr 10.

Myoepithelial carcinoma of major salivary glands: Analysis of population-based clinicopathologic and prognostic features

Yunxiu Luo  1
Affiliations

Myoepithelial carcinoma of major salivary glands: Analysis of population-based clinicopathologic and prognostic features

Yunxiu Luo. Transl Oncol. 2022 Jun.

Abstract

Background: This study aimed to investigate the effect of demographic characteristics and disease stage on the survival outcomes of patients with myoepithelial carcinoma (MECA) of the salivary glands, and to assess the role of radiotherapy in these patients.

Methods: The Epidemiology, Surveillance and End Results database was queried from 2000 to 2018 to identify patients with MECA. Data pertaining to the tumor stage, size, histological grade, and demographic characteristics were analyzed. The relationship between clinicopathological features and overall survival (OS) was assessed using statistical analyses.

Results: In total, 290 patients (137 men and 153 women) were identified. The parotid gland was the most common tumor location (76.6% patients). Approximately half of the patients had locally advanced tumors, and 14.5 and 6.6% had lymph node and distant organ involvement, respectively. The median OS was 142 months, while the survival rates at 120 months and 180 months were 53% and 39%, respectively. In the cohort, 160 patients (55.2%) underwent surgery alone, while 130 patients (44.8%) underwent surgery combined with radiotherapy. Multivariate Cox analysis revealed that histopathological grade, stage, T3 stage (hazard ratio [HR]: 2.47, P = 0.039), T4 stage (HR: 3.33, P = 0.011), N2 stage (HR: 6.59, P = 0.002), and M1 stage (HR: 2.72, 95%confidence interval [CI]: 1.03-7.19; P = 0.044) were associated with poor prognosis. Radiotherapy (HR: 0.58, P = 0.042) was a favorable factor for OS, and it reduced the mortality risk by 42%.

Conclusions: Histological grade, stage, and radiotherapy are independent risk factors for OS. The decision to administer chemotherapy for MECA should be made with caution. Adjuvant radiotherapy is recommended in high-risk patients.

Keywords: Myoepithelial carcinoma; Population; Prognosis; Radiotherapy; Salivary gland; Surveillance epidemiology and end results.

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Conflict of interest statement

The authors declare no conflicts of interest

Figures

Fig. 1
Fig. 1
Cumulative overall survival (OS) curves for patients with myoepithelial carcinoma (MECA) before (upper row) and after PSM (bottom row). (a and b) OS; (c and d) radiotherapy; (e and f), chemotherapy. PSM, propensity score matching.
Fig. 2
Fig. 2
Stratified analysis of OS for patients with MECA before PSM (upper row) and after PSM (bottom row). (a and b) different age-groups; (c and d) grade; (e and f) stage. PSM, propensity score matching; MECA, myoepithelial carcinoma.
Fig. 3
Fig. 3
Stratified analysis of OS for patients with MECA before PSM (upper row) and after PSM (bottom row). (a and b) T stage; (c and d) N stage; (e and f) M stage. MECA, myoepithelial carcinoma; T, tumor; N, lymph node; M, metastasis.
Fig. 4
Fig. 4
Stratified analysis of Cancer-specific survival (CSS) for patients with MECA before PSM (upper row) and after PSM (bottom row). (a and b) overall CSS; (c and d) grade; (e and f) chemotherapy; (g and h) radiotherapy. MECA, myoepithelial carcinoma.
Fig. 5
Fig. 5
Stratified Kaplan-Meier cancer-specific survival (CSS) curves for patients with MECA before PSM (upper row) and after PSM (bottom row). (a and b) stage; (c and d) T stage; (e and f) N stage; (g and h) M stage. MECA, myoepithelial carcinoma.
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