Overall and cause-specific survival for mucoepidermoid carcinoma of the major salivary glands: Analysis of 2210 patients

Taylor, Zachary; Kaya, Erin A; Bunn, Jeffrey D; Guss, Zachary D.; Mitchell, Brian J.; Fairbanks, Robert K.; Lamoreaux, Wayne T.; Wagner, A.; Peressini, Ben; Lee, Christopher M.

doi:10.5306/wjco.v11.i12.1029

Cited by 13 publications

(11 citation statements)

References 40 publications

(29 reference statements)

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“…Sex was proven to be an independent risk factor of MSGC survival. Females have been reported to have better survival outcomes compared with males, which is consistent with our result (26,29). Not surprisingly, the risk increases with the patients' age.…”

Section: Discussionsupporting

confidence: 92%

“…T stage and tumor size reflected the condition of the primary site. Interestingly, the patient with a larger primary lesion might have better survival compared to a smaller lesion, which was contradictory to the results of other studies (29). On the one hand, the larger tumor was often associated with better differentiation grade and histological type, which led to better survival outcomes.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Nomograms-based prediction of overall and cancer-specific survivals for patients diagnosed with major salivary gland carcinoma

Guo¹,

Wang²,

Liu³

et al. 2021

Ann Transl Med

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Background: Major salivary glands carcinoma (MSGC) is a relatively rare cancer with diverse histological types and biological behavior. The treatment planning and prognosis prediction are challenging for clinicians. The aim of the current study was to establish a reliable and effective nomogram to predict the overall survival (OS) and cancer-specific survival (CSS) for MSGC patients.Methods: Patients pathologically diagnosed with MSGC were recruited from Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training and validation groups (7:3 ratio).Univariate, multivariate Cox proportional hazard models, and least absolute shrinkage and selection operator (LASSO) regression were adopted for the selection of risk factors. Nomograms were developed using R software. The model performance was evaluated by drawing receiver operating characteristic (ROC), overtime C-index curves, and calibration curves. Harrell C-index, areas under the curves (AUC), and Brier score were also calculated. The decision curve analysis (DCA) was conducted to measure the net clinical benefit.Results: A total of 11,362 patients were identified and divided into training (n=7,953) and validation (n=3,409) dataset. Sex, age, race, marital status, site, differentiation grade, American Joint Committee on Cancer (AJCC) stage, T/N/M stage, tumor size, surgery, and histological type were incorporated into the Cox hazard model for OS prediction after variable selection, while all predictors, except for marital status and site, were selected for CSS prediction. For 5-year prediction, the AUC of the nomogram for OS and CSS was 83.5 and 82.7 in the training and validation dataset, respectively. The C-index was 0.787 for OS and 0.798 for CSS in the validation group. The Brier score was 0.0153 and 0.0130 for OS and CSS, respectively. The calibration curves showed that the nomogram had well prediction accuracy. From the perspective of DCA, a nomogram was superior to the AJCC stage and TNM stage in net benefit. In general, the performance of the nomogram was consistently better compared to the AJCC stage and TNM stage across all settings.Conclusions: The performance of the novel nomogram for predicting OS and CSS of MSGC patients was further verified, revealing that it could be used as a valuable tool in assisting clinical decision-making.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 58%

Nomograms-based prediction of overall and cancer-specific survivals for patients diagnosed with major salivary gland carcinoma

Guo¹,

Wang²,

Liu³

et al. 2021

Ann Transl Med

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“…In this study, we have investigated clinical, histological, and molecular predictors of survival of MEC patients in two large patient cohorts, one from the HRC pathology (n = 167) and one from the population-based LKR-NRW cancer [1,26]. Interestingly, as previously shown by Taylor et al, men with MECs of the major salivary glands have shorter survival than women which may be due to a higher proportion of G3-MECs among men compared to women [27]. In contrast to Taylor et al, we also studied the survival of patients with minor salivary gland MECs.…”

Section: Discussionmentioning

confidence: 88%

“…Interestingly, as previously shown by Taylor et al, men with MECs of the major salivary glands have shorter survival than women which may be due to a higher proportion of G3-MECs among men compared to women [ 27 ]. In contrast to Taylor et al, we also studied the survival of patients with minor salivary gland MECs.…”

Section: Discussionmentioning

confidence: 91%

Mucoepidermoid carcinoma of the salivary glands revisited with special reference to histologic grading and CRTC1/3-MAML2 genotyping

et al. 2021

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Mucoepidermoid carcinoma (MEC) is the most common carcinoma of the salivary glands. Here, we have used two large patient cohorts with MECs comprising 551 tumors to study clinical, histological, and molecular predictors of survival. One cohort (n = 167), with known CRCT1/3-MAML2 fusion status, was derived from the Hamburg Reference Centre (HRC; graded with the AFIP and Brandwein systems) and the other (n = 384) was derived from the population-based Cancer Registry of North Rhine-Westphalia (LKR-NRW; graded with the AFIP system). The reliability of both the AFIP and Brandwein grading systems was excellent (n = 155). The weighted kappa for inter-rater agreement was 0.81 (95% CI 0.65–0.97) and 0.83 (95% CI 0.71–0.96) for the AFIP and Brandwein systems, respectively. The 5-year relative survival was 79.7% (95% CI 73.2–86.2%). Although the Brandwein system resulted in a higher rate of G3-MECs, survival in G3-tumors (AFIP or Brandwein grading) was markedly worse than in G1/G2-tumors. Survival in > T2 tumors was markedly worse than in those with lower T-stage. Also, fusion-negative MECs had a worse 5-year progression-free survival. The frequency of fusion-positive MECs in the HRC cohort was 78.4%, of which the majority (86.7%) was G1/G2-tumors. In conclusion, the AFIP and Brandwein systems are useful in estimating prognosis and to guide therapy for G3-MECs. However, their significance regarding young age (≤ 30 years) and location-dependent heterogeneity of in particular G2-tumors is more questionable. We conclude that CRTC1/3-MAML2 testing is a useful adjunct to histologic scoring of MECs and for pinpointing tumors with poor prognosis with higher precision, thus avoiding overtreatment.

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“…low-grade salivary gland MEC is excellent, that of high-grade tumor is poor. 7,8 Approximately 60% of salivary MECs harbor a translocation, t (11;19)(q21;p13), resulting in the CRTC1-MAML2 fusion transcript. [9][10][11][12] Rare cases display t(11;15)(q21;q26) with CRTC3-MAML2 fusion.…”

mentioning

confidence: 99%

Thymic Mucoepidermoid Carcinoma

Murase

Nakano²,

Sakane³

et al. 2022

American Journal of Surgical Pathology

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Thymic mucoepidermoid carcinoma (MEC) is a rare tumor, and its characteristics remain to be clarified. Here we investigated 20 cases of thymic MEC to systematically characterize its clinical, histopathologic, and molecular features. The median age of the patients was 56 years (range, 19 to 80 y), there was a slight male predilection (3:2), and 44% of the patients were asymptomatic at diagnosis. The median tumor size was 6.8 cm in diameter, 55% were pT1 tumors, and 50% were TNM stage I tumors. When 4 tumor grading systems for salivary MEC (Armed Forces Institutes of Pathology, Brandwein, modified Healey, and the Memorial Sloan-Kettering) were employed, low-grade, intermediate-grade, and high-grade tumors accounted for 35% to 70%, 5% to 25%, and 25% to 50%, respectively. Many histologic variants were noted, and 70% of the cases were classified as nonclassic variants. MAML2 rearrangement was detected in 56% of cases, and the fusion partner was CRTC1 in all cases. CRTC1-MAML2 fusion was associated with lower pT classification and lower TNM stage. The overall survival rate of all patients was 69% and 43% at 5 and 10 years, respectively. Worse overall survival was associated with higher pT stage, higher TNM stage, residual tumors, greater tumor size, high-grade tumor histology (Armed Forces Institutes of Pathology and Memorial Sloan-Kettering, but not the other 2), and with the absence of CRTC1-MAML2 fusion. Of note, none of the patients with CRTC1-MAML2 fusion-positive tumors died during the follow-up. In conclusion, the clinicopathologic and molecular findings of thymic MEC presented here are expected to contribute to the management of this rare tumor.

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Overall and cause-specific survival for mucoepidermoid carcinoma of the major salivary glands: Analysis of 2210 patients

Cited by 13 publications

References 40 publications

Nomograms-based prediction of overall and cancer-specific survivals for patients diagnosed with major salivary gland carcinoma

Nomograms-based prediction of overall and cancer-specific survivals for patients diagnosed with major salivary gland carcinoma

Mucoepidermoid carcinoma of the salivary glands revisited with special reference to histologic grading and CRTC1/3-MAML2 genotyping

Thymic Mucoepidermoid Carcinoma

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