Factores pronósticos en carcinoma mucoepidermoide de cabeza y cuello / Prognostic factors in head and neck mucoepidermoid carcinoma

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% of the patients. 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 all correlated with a poor prognosis. CONCLUSIONS: 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.