Histocytologic grading of mucoepidermoid carcinoma of major salivary glands in prognosis and survival: A clinicopathologic and flow cytometric investigation

M. John Hicks, Adel K. El‐Naggar, Catherine M. Flaitz, Mario A. Luna, John G. Batsakis

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91 Scopus citations

Abstract

Background. Controversy exists regarding the role of a 3‐tiered grading system for mucoepidermoid carcinoma (MEC) of salivary glands in prognosis and survival. This retrospective investigation evaluated a 3‐tiered grading system modified from Healey by Batsakis and Luna and compared various clinical, pathologic, and flow cytometric parameters and overall survival among MECs of differing grades. Methods. Forty‐eight patients with 7 low‐grade (LG), 23 Intermediate‐grade (IG), and 18 high‐grade (HG) MECs of parotid (n = 43) and submandibular (n = 5) glands were studied. Data were analyzed using categorical statistics (Wilcoxon, Kruskal‐Wallis and Chi‐squared tests where appropriate). Results. Mean ages were 42 years for patients with LG tumors; 47 years, IG; and 59 years, HG (p = 0.02). Gender ratio (p < 0.001) changed from female predominance in LG (6 F:1 M) and IG (2.1 F:1 M) to male predominance in HG (3.5 M:1 F). Mean tumor stage was 1.4 LG, 2.4 lG, and 3.6 HG (p < 0.005). Tumor size increased from 2.1 cm for LG to 3.8 cm for HG (p = 0.01). Margins were involved by tumor in 0% LG, 44% IG, and 61% HG (p < 0.001). Lymph node involvement was 0% LG, 22% IG, and 72% HG (p < 0.001). DNA aneuploidy (DNA index < 0.9 or > 1.1) was present in 0% LG, 13% IG, and 28% HG (p = 0.05). Proliferative fraction (S + G2M) was 5% LG, 7% IG, and 13% HG (p = 0.008). Radiotherapy was administered in 14% LG, 35% IG, and 61% HG (p = 0.03). Recurrences (local and/or metastatic) occurred in 0% LG, 39% IG, and 61% HG (p = 0.009). Survival was decreased significantly (p < 0.0001) with increasing tumor grade (100% LG, 70% IG, and 22% HG). Conclusion. Histologic grading of mucoepidermoid carcinomas of major salivary glands, using the modified Healey 3‐tiered system, correlates well with clinical, pathologic, and flow cytometric factors which influence the prognosis and overall survival in affected individuals. © 1995 Jons Wiley & Sons, Inc.

Original languageEnglish (US)
Pages (from-to)89-95
Number of pages7
JournalHead & Neck
Volume17
Issue number2
DOIs
StatePublished - 1995

ASJC Scopus subject areas

  • Otorhinolaryngology

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