Dados do Resumo

Título

Mucoepidermoid Carcinoma of Salivary Glands: Evaluation of Prognostic and Therapeutic Factors

Introdução

Mucoepidermoid carcinoma (MEC) is the most common salivary gland neoplasm, accounting for up to 1% of all malignant neoplasms and 7% of head and neck cancers. The main treatment is surgical resection, with or without adjuvant radiotherapy and chemotherapy (RTa/QTa), taking into account prognostic factors such as histological grade, margins and compromised lymph nodes.

Objetivo

To determine the prognostic factors and correlate them with the multimodal therapy performed on patients diagnosed with CME and treated between 01/2006 and 12/2019 at the A.C. Camargo Cancer Center.

Métodos

After CEP approval (3140-21), an observational, descriptive and retrospective analysis of patient demographics, tumor morphological and histopathological criteria, and therapy was carried out on 83 medical records, focusing on their impact on Overall Survival (OS), Disease-Free Survival (DFS) and Locoregional Control (LC). To this end, survival rates were obtained using the curves derived from the Kaplan Meier method, and the LogRank test was used to determine whether there was a statistically significant difference (p>0.05) between them, as well as multivariate COX regression analysis to establish the independent risk factors for the onset of the event (death/recurrence).

Resultados

It was found that 47 (57.3%) patients were female and 35 (42.7%) male. As for the location of the primary tumor, 53 (64.6%) had it in the major salivary gland compared to the rest in minor salivary glands, corroborating the most recent literature. With regard to the histological subtype, 49 (59.7%) had a low grade. As treatment, 42 (51.2%) underwent surgery alone, 31 (37.8%) underwent surgery and RTa, and 9 (11%) underwent surgery and RTa plus QTa. There was a significant association between SLD and CL and the 'compromised margins' factor, as well as between SG and 'lymph node involvement' and 'tumor >= 4cm'. When analyzed in association, the variables 'tumor size>=4cm' and 'lymph node involvement' stood out even more as prognostic factors.

Conclusões

The surgical margin was identified as an independent risk factor for local or distant recurrence, as were tumors larger than 4cm, the presence of lymph node involvement and higher clinical and pathological staging for the outcome of death. Multimodal therapy showed a slight increase in the OS and CL rates, with no effect on the DFS, but this was not statistically significant. Therefore, longitudinal studies, such as randomized clinical trials, are needed to validate the results, including a larger cohort of patients for a more in-depth analysis.

Financiador do resumo

CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico

Palavras Chave

mucoepidermoid carcinoma; Salivary Gland Neoplasms; Adjuvant Radiotherapy