Head And Heck Mucoepidermoid Carcinoma: Clinicopathologic Study Of 173 Cases

Introduction: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor, however few studies have been reported in Brazilian populations. Aim: To report clinical and pathologic data from 173 head and neck MEC treated in the Treatment and Research Center at Hospital do Câncer A. C. Camargo in São Paulo. Study design: Clinical randomized. Material and Method: From 1953 to 1997, 173 cases of MEC were found in the medical files of the center. Data were obtained from the patients' records and histological review of all cases. Results: The mean age of the patients was 44 years and 93 (53.8%) were men; parotid glands were affected in 61 cases (35.2%) and intraoral minor salivary glands in 75 (43.4%). TNM revealed 50.3% of the cases in stages I and II, and histological grading revealed 45.2%, 18.5% and 36.3% low-grade, intermediate-grade and high-grade tumors, respectively. Surgical treatment was employed in 80.3% of the cases, with neck dissection in 52 cases (30.1%), and radiotherapy in 73 (42.2%). Local recurrence, regional and distant metastases were found in 12.7%, 9.8% and 9.2% of the patients, respectively; 5-year and 10-year overall survival rates were 70% and 60%, respectively. Conclusions: MEC affected mainly the parotid gland and the palate of adults, without gender preference. Half of the cases were diagnosed at initial clinical stages and 64% of the tumors were low or intermediate-grade lesions. Surgery was the treatment of choice and prognosis was good.685679684Ellis, G.L., Auclair, P.L., Gnepp, D.R., Surgical Pathology of the salivary glands (1991) Major Problems in Pathology Series, 25. , Philadelphia: WB Saunders CompanyEllis, G.L., Auclair, P.L., Tumors of the Salivary Glands (1996) Armed Forces Institute of Pathology. Atlas of Tumor Pathology. 3 rd Series, , Fascicle 17. WashingtonAuclair, P.L., Goode, R.K., Ellis, G.L., Mucoepidermoid carcinoma of intraoral salivary glands (1992) Cancer, 69, pp. 2021-2030Cardoso, W.P., Denardin, O.V., Rapoport, A., Araujo, V.C., Carvalho, M.B., Proliferating cell nuclear antigen expression in mucoepidermoid carcinoma of salivary glands (2000) São Paulo Med J, 118, pp. 69-74Goode, R.K., Auclair, P.L., Ellis, G.L., Mucoepidermoid carcinoma of the major salivary glands: Clinical and histopathologic analysis of 234 cases with evaluation of grading criteria (1998) Cancer, 82, pp. 1217-1224Brandwein, M.S., Ivanov, K., Wallace, D.I., Hille, J.J., Wang, B., Fahmy, A., Bodian, C., Mills, S.E., Mucoepidermoid carcinoma: A clinicopathologic study of 80 patients with special reference to histological grading (2001) Am J Surg Pathol, 25, pp. 835-845Evans, H.L., Mucoepidermoid carcinoma of salivary glands: A study of 69 cases with special attention to histologic grading (1984) Am J Clin Pathol, 81, pp. 696-701Nascimento, A.G., Amaral, A.L.P., Prado, L.A.F., Kligerman, J., Silveira, T.R.P., Mucoepidermoid carcinoma of salivary glands: A clinicopathologic study of 46 cases (1986) Head Neck Surg, 8, pp. 409-417Plambeck, K., Friedrich, R.E., Bahlo, M., Bartel-Friedrich, S., Klapdor, R., TNM staging, histopathological grading, and tumor-associated antigens in patients with a history of mucoepidermoid carcinoma of the salivary glands (1999) Anticancer Res, 19, pp. 2397-2404Spiro, R.H., Huvos, A.G., Berk, R., Strong, E.W., Mucoepidermoid carcinoma of salivary gland origin: A clinicopathologic study of 367 cases (1978) Am J Surg, 136, pp. 461-468Chinellato, L.E.M., Marquez, I.M., Fleury, R.N., Quevedo, F.C., Estudos da prevalência dos tumores de origem epitelial de glândulas salivares em Serviços de Anatomia Patológica das cidades de Bauru e Jaú (Estado de São Paulo, Brasil) (1994) Rev Fac Odontol Bauru, 2, pp. 45-51Franzi, A.S., Carvalho, M.B., Carcinoma mucoepidermóide avançado das glândulas salivares (1997) Rev Bras Cancerol, 43, pp. 273-280Kusama, K., Iwanari, S., Aisaki, K., Wada, M., Ohtani, J., Itoi, K., Hanai, K., Moro, I., Intraoral minor salivary gland tumors: A retrospective study of 129 cases (1997) J Nihon Univ Sch Dent, 39, pp. 128-132Lopes, M.A., Kowalski, L.P., Santos, G.C., Almeida, O.P., A clinicopathologic study of 196 intraoral minor salivary gland tumors (1999) J Oral Pathol Med, 28, pp. 264-267Loyola, A.M., De Araujo, V.C., De Sousa, S.O.M., De Araujo, N.S., Minor salivary gland tumours: A retrospective study of 164 cases in a Brazilian population (1995) Oral Oncol Eur J Cancer, 31 B, pp. 197-201Rapoport, A., De Andrade Sobrinho, J., Brasilino De Carvalho, M., Magrin, J., Fava, A.S., Cancer of the parotid gland (1981) Int Surg, 66, pp. 243-246Rapoport, A., Carvalho, M.B., Fava, A.S., Góis Filho, J.F., Chagas, J.F.S., Kowalski, L.P., Kanda, J.L., Cheuhen, J.A., Diagnóstico e tratamento das neoplasias das glândulas salivares menores: Estudo de 55 casos (1988) Rev Col Bras Cirur, 15, pp. 289-293Regis De Brito Santos, I., Kowalski, L.P., Cavalcante De Araujo, V., Flavia Logullo, A., Magrin, J., Multivariate analysis of risk factors for neck metastasis in surgically treated parotid carcinomas (2001) Arch Otolaryngol Head Neck Surg, 127, pp. 56-60Spiro, R.H., Thaler, H.T., Hicks, W.F., Kher, U.A., Huvos, A.H., Strong, E.W., The importance of clinical staging of minor salivary gland carcinoma (1991) Am J Surg, 162, pp. 330-336Hicks, M.J., El-Naggar, A.K., Flaitz, C.M., Luna, M.A., Batsakis, J.G., Histocytologic grading of mucoepidermoid carcinoma of major salivary glands in prognosis and survival: A clinicopathologic and flow cytometric investigation (1995) Head Neck, 17, pp. 89-95Hicks, J., Flaitz, C., Mucoepidermoid carcinoma of salivary glands in children and adolescents: Assessment of proliferation markers (2000) Oral Oncol, 36, pp. 454-460Ma'aita, J.K., Al-Kalsi, N., Al-Tamimi, S., Wraikat, A., Salivary gland tumors in Jordan: A retrospective study of 221 patients (1999) Croat Med J, 40, pp. 539-54