Predictors of recurrence and survival for head and neck mucoepidermoid carcinoma

Objective. To describe the epidemiology and determine the clinicopathologic predictors of recurrence and survival in patients with head and neck mucoepidermoid carcinoma (MEC). Study Design. Case series with chart review. Setting. Tertiary care hospital. Subjects and Methods. The medical records of 101 patients who underwent surgical treatment at the University of Michigan for head and neck MEC between 1985 and 2010 were reviewed. Main outcome measures were disease-free survival (DFS), disease-specific survival (DSS), and overall survival. Clinicopathologic parameters evaluated were age, sex, subsite, histological grade, adjuvant therapy, T stage, nodal status with/without extracapsular spread, and margin status. Results. Of the 101 patients, 38 parotid, 33 palate, 17 oral, 8 submandibular/sublingual, 4 orbital, and 1 parapharyngeal carcinomas were identified. All patients underwent surgical resection, 23 had postoperative radiation, and 2 had postoperative chemoradiation. The 5-year OS and DSS was 79% and 95% with a median follow-up of 72 and 45 months, respectively. Five-year DFS was 76%. On univariate analysis, histological grade was a statistically significant predictor of disease-free survival (P = .001) and overall survival (P = .04). Positive nodal status was a significant predictor of DSS (P = .004). There was no statistically significant difference in DFS, DSS, or OS based on sex, age, anatomic subsite, T stage, adjuvant therapy, and margin status. Conclusion. Advanced histological grade and positive nodal status are the strongest independent predictors of prognosis in head and neck MEC patients. Further studies into the molecular biology of MEC that may account for such clinicopathological features are currently underway.