David Geffen School of Medicine, University of California Irvine, Irvine.
Department of Head and Neck Surgery, University of California Irvine, Irvine.
Laryngoscope. 2018 May;128(5):1083-1092. doi: 10.1002/lary.26832. Epub 2017 Aug 22.
Identify the effect of patient characteristics, disease traits, and treatment modality on patient outcomes in the rare disease process of intraosseous mucoepidermoid carcinoma.
Retrospective review of institutional case records and literature.
This study includes one case report, a literature review of the MEDLINE database from 1950 through June 2017 using keywords "intraosseous" and "mucoepidermoid," and a query of the University of California, Los Angeles, Department of Pathology database for all documented cases of intraosseous mucoepidermoid carcinoma of the head and neck.
Indicators of poorer prognosis were male gender (P = 0.0071) and higher histological grade (P = 0.0095). Lesion site, size, association with odontogenic cyst, and treatment type did not have a statistically significant correlation with patient outcomes. There also was no statistically significant correlation observed between treatment modality and recurrent or progressive disease when stratified by histological grade of the cancer.
This study identified male gender and high histological tumor grade as poor prognostic indicators; however, it did not reveal a statistically significant relationship between treatment modality and patient outcomes. Data regarding patient outcomes following treatment was limited due to loss to follow-up, suggesting that further investigation is required. Based on this review, decisions regarding treatment should be clinically guided and individually tailored to the patient's baseline health, disease severity, and the patient's treatment goals. A multi-disciplinary conference, as was utilized in the presented case report, may be the best approach to treatment planning for these patients at this time.
确定患者特征、疾病特征和治疗方式对罕见的骨内黏液表皮样癌患者预后的影响。
回顾性分析机构病历和文献。
本研究包括 1 例病例报告,对 1950 年至 2017 年 6 月 MEDLINE 数据库进行了文献复习,使用了“骨内”和“黏液表皮样癌”的关键词,并对加利福尼亚大学洛杉矶分校病理学系数据库进行了查询,以获取所有记录在案的头颈部骨内黏液表皮样癌病例。
预后较差的指标是男性(P=0.0071)和高组织学分级(P=0.0095)。病变部位、大小、与牙源性囊肿的关系以及治疗类型与患者预后无统计学显著相关性。当按癌症的组织学分级对治疗方式进行分层时,治疗方式与复发性或进行性疾病之间也没有观察到统计学显著相关性。
本研究确定了男性和高组织学肿瘤分级为不良预后指标;然而,它并没有揭示治疗方式与患者预后之间的统计学显著关系。由于失访,治疗后患者结局的数据有限,这表明需要进一步调查。基于本综述,治疗决策应基于临床,并根据患者的基线健康状况、疾病严重程度和患者的治疗目标进行个体化调整。多学科会议,如本病例报告中所采用的那样,可能是目前治疗这些患者的最佳方法。