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Prognostic Factors in Head and Neck Mucoepidermoid Carcinoma
Fábio Ramôa Pires, PhD;
Oslei Paes de Almeida, PhD;
Vera Cavalcanti de Araújo, PhD;
Luiz Paulo Kowalski, PhD
Arch Otolaryngol Head Neck Surg. 2004;130:174-180.
Objective To analyze clinical, histological, and immunohistochemical prognostic factors in a large series of patients with mucoepidermoid carcinoma (MEC) treated in a single institution, using univariate and multivariate survival analyses.
Design Inception cohort.
Setting Referral center.
Patients All patients diagnosed with head and neck MEC from a single cancer referral center from January 19, 1957, to July 12, 1997.
Main Outcome Measures Rates of local recurrence, regional and distant metastasis, and overall actuarial survival.
Results Men represented 53.8% of the cohort, and the parotid gland and palate were affected by MEC in 35.2% and 23.7%, respectively. TNM stage I or II lesions comprised 50.3% of the tumors, and low-grade tumors comprised 45.2%, and the 5-year overall survival was 70.2%. Univariate survival analysis revealed that age older than 40 years (P<.001), male sex (P = .005), fixed tumors (P = .002), invasion of adjacent structures (P = .004), T stage (P<.001), N stage (P<.001), clinical stage (P<.001), histological grade (P<.001), and expression of proliferating cell nuclear antigen (P<.001), Ki-67 (P<.001), and p53 (P<.001) correlated with a poor prognosis. Expression of carcinoembryonic antigen (P = .01) and bcl-2 (P<.001) correlated with a better prognosis.
Conclusion Age older than 40 years, fixed tumors, T and N stage, and histological grade are independent significant prognostic factors in patients with MEC.
From the Section of Oral Pathology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, State University of Campinas, Piracicaba (Drs Pires and Paes de Almeida); and the Section of Oral Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (Dr Cavalcanti de Araújo), and Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Hospital (Dr Kowalski), São Paulo, Brazil. The authors have no relevant financial interest in this article.
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