| Objective: The incidence of mucoepidermoid carcinoma(MEC)arised from salivary gland is highest among all salivary gland malignancies.Study based on Chinese population is insufficient and most reports had very limited patient number.This study retrospectively analyzed the patients with salivary gland MEC treated in Sichuan Cancer Hospital in the last decade and explored the related clinical factors affecting the prognosis of the salivary gland MEC.Methods: To collect data of patients with salivary gland MEC who were hospitalized in Sichuan Cancer Hospital in the past decade and to follow up their survival.Pathological sections were graded by a senior pathologist according to the Armed Forces Institute of Pathology(AFIP)scoring system.The clinical factors affecting the prognosis of patients with salivary gland MEC were retrospectively analyzed.The SPSS 23.0 software was used for statistical description and inference.The survival rates were estimated and survival curves were generated by Kaplan-Meier method.Log-Rank test is used to compare the significance of difference between groups.COX regression model was used to perform multivariate analysis of independent prognostic factors.? was determined as 0.05.P<0.05 was recognized as statistically significant.Results: From February 2006 to February 2017,a total of 148 patients were treated in Sichuan Cancer Hospital.52 patients were excluded because of incomplete pathological and clinical records.96 patients with salivary gland MEC were included in this study.Patients' median age is 46 years(range,11-80 years),male to female ratio is 1:1.5.The primary sites are as follows: 20 cases from small salivary gland,including 15 from palatine gland,3 from retromolar gland,2 from buccal mucosa gland;63 from parotid gland,8 from submandibular gland,and 5 from sublingual gland.T category classifications are: T1 26 cases,T2 38 cases,T3 10 cases,T4 22 cases,N category classifications are: N0 76 cases,N1 17 cases,and N2 3 cases;clinical stages are: stage I 23 cases,stage II 30 cases,stage III 20 cases,and stage IV 23 cases.Tumors were categorized as high grade(21 cases),intermediate grade(15 cases),and low grade(60 cases)based on AFIP score.All patients received surgery,of whom,31 patients received post-operative radiotherapy,17 cases received adjuvant chemotherapy.The median follow-up is 48 months(range,4-135 months).During follow-up,11 patients developed recurrence;8 patients developed local recurrence,3 patients developed both local and neck regional lymph nodes recurrence,2 patients developed distant metastases.6 patients were died of MEC.The 3-year,5-year,10-year disease-free survival(DFS)and overall survival(OS)are: 90.3% and 94.8%?85.7% and 94.8%?68.6% and 79.9%.Univariate analysis suggested that nodal involvement,high grade were associated with worse DFS,whereas male,nodal involvement,and high grade were associated with worse OS than counterparts.Multivariate analysis revealed that lymph node stage and pathological grade are independent prognostic factors for both DFS and OS.Patients received post-operative radiotherapy have superior long-term DFS,however,such survival difference is not statistically significant.There is no evidence that patient could benefit from adjuvant chemotherapy.In addition,for the 63 parotid gland MECs,radical parotidectomy is an independent predictor from pathological grade for DFS.Conclusions: 1.MEC from salivary gland has relative good prognosis after receiving combined and normative therapy in which surgery is the base;2.Lymph node stage and pathological grade are independent prognostic factors that correlated with both DFS and OS;Lymph node involvement and high pathological grade should take positive comprehensive treatment.3.For parotid gland MEC,radical parotidectomy should be the choice of surgical procedure which can improve disease control. |
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