Survival Outcomes and Factors Affecting Prognosis in Patients with Head and Neck Region Mucoepidermoid Carcinoma Treated with Adjuvant Radiotherapy

Mursel DUZOVA, Mustafa AKIN
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 Material and Method: In this retrospective review, medical records of 42 patients who underwent surgery and subsequent radiotherapy for localized MEC in the major and minor salivary glands of the head and neck were analyzed to identify clinicopathological determinants of overall survival. Secondary endpoints encompassed local-regional control, distant metastasis-free survival, and disease-free survival.
 Results: The median age of the patient cohort was 56 years, comprising 52.4% males and 47.6% females. The median follow-up period spanned 36 months, with a range of 6 to 88 months. All patients underwent curative surgery, followed by adjuvant radiotherapy. The 2-year and 5-year rates for overall survival (OS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 92% and 72.6%, 92.2% and 85.6%, 84.8% and 73%, 82% and 67.3%, respectively. Notably, only histologic grade emerged as a statistically significant prognostic factor, influencing both OS (p=0.019), DMFS (p=0.014), and DFS (p=0.044).
 Conclusion: The histologic grade of the tumor is the foremost determinant impacting the outcomes of MEC cases. Adjuvant radiotherapy is recommended for high-grade tumors, while its application for low-grade and intermediate-grade tumors should be individualized based on the anticipated risk of recurrence. This underscores the significance of tailoring treatment approaches according to histologic characteristics.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"68 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of contemporary medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.16899/jcm.1345383","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

Aim: This study aims to ascertain the clinical and pathological factors linked to the outcomes of patients subjected to surgical intervention and postoperative radiotherapy for mucoepidermoid carcinoma (MEC) originating from both major and minor salivary glands in the head and neck region. Material and Method: In this retrospective review, medical records of 42 patients who underwent surgery and subsequent radiotherapy for localized MEC in the major and minor salivary glands of the head and neck were analyzed to identify clinicopathological determinants of overall survival. Secondary endpoints encompassed local-regional control, distant metastasis-free survival, and disease-free survival. Results: The median age of the patient cohort was 56 years, comprising 52.4% males and 47.6% females. The median follow-up period spanned 36 months, with a range of 6 to 88 months. All patients underwent curative surgery, followed by adjuvant radiotherapy. The 2-year and 5-year rates for overall survival (OS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 92% and 72.6%, 92.2% and 85.6%, 84.8% and 73%, 82% and 67.3%, respectively. Notably, only histologic grade emerged as a statistically significant prognostic factor, influencing both OS (p=0.019), DMFS (p=0.014), and DFS (p=0.044). Conclusion: The histologic grade of the tumor is the foremost determinant impacting the outcomes of MEC cases. Adjuvant radiotherapy is recommended for high-grade tumors, while its application for low-grade and intermediate-grade tumors should be individualized based on the anticipated risk of recurrence. This underscores the significance of tailoring treatment approaches according to histologic characteristics.
头颈部黏液表皮样癌辅助放疗患者的生存结局及影响预后的因素
目的:本研究旨在探讨影响头颈部大小唾液腺粘液表皮样癌(MEC)患者手术治疗及术后放疗预后的临床及病理因素。材料和方法:本研究回顾性分析了42例头颈部大、小唾液腺局部MEC的手术和放疗患者的病历,以确定总生存期的临床病理决定因素。次要终点包括局部-区域控制、远处无转移生存期和无病生存期。 结果:患者队列的中位年龄为56岁,男性占52.4%,女性占47.6%。中位随访期为36个月,范围为6至88个月。所有患者均行根治性手术,随后行辅助放疗。2年和5年的总生存率(OS)、局部-区域无复发生存率(LRFS)、远处无转移生存率(DMFS)和无病生存率(DFS)分别为92%和72.6%、92.2%和85.6%、84.8%和73%、82%和67.3%。值得注意的是,只有组织学分级成为具有统计学意义的预后因素,影响OS (p=0.019)、DMFS (p=0.014)和DFS (p=0.044)。 结论:肿瘤的组织学分级是影响MEC预后的首要决定因素。对于高级别肿瘤推荐使用辅助放疗,对于低级别和中级别肿瘤应根据预期复发风险进行个体化治疗。这强调了根据组织学特征定制治疗方法的重要性。
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