Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Department of Otolaryngology-Head and Neck Surgery, Irvine Medical Center, University of California, Orange, CA.
Int Forum Allergy Rhinol. 2019 Sep;9(9):1046-1053. doi: 10.1002/alr.22379. Epub 2019 Jul 17.
Primary sinonasal mucoepidermoid carcinoma (SN-MEC) is a malignancy arising from seromucinous glands of the nasal cavity and paranasal sinuses. Given its rarity, few large-scale studies have been performed. In this study we describe the incidence and determinants of survival of patients with SN-MEC leveraging the National Cancer Database (NCDB).
This was a retrospective, population-based cohort study of patients diagnosed with SN-MEC between 2004 and 2012 within the NCDB. The main outcome measure was overall survival (OS).
A total of 164 patients were identified. The cohort was composed of 47.6% males. Mean age at diagnosis was 59.7 years. The maxillary sinus was the most common primary site, accounting for 45.7% of cases. Eleven percent of patients presented with nodal disease, whereas 2.1% had distant metastases. Stage IV disease was seen in 30.4% of cases. A total of 79.8% of the patients underwent surgery, 61.0% received radiation therapy, and 15.1% had chemotherapy. OS at 1, 2, and 5 years was 83%, 77.0%, and 57%, respectively. On multivariate analysis, Medicaid insurance status (hazard ratio [HR], 7.29; 95% confidence interval [CI], 1.74-30.57), advanced tumor size (HR, 4.94; 95% CI, 1.19-20.5), and advanced nodal disease (N1: HR, 9.48; 95% CI, 1.66-54.23; N2B: HR, 19.3; 95% CI, 1.07-350.64) were associated with worse OS.
Mucoepidermoid carcinoma is the most common salivary gland malignancy but a rare sinonasal malignancy, with 5-year survival for SN-MEC approximating 50%. A significant proportion of patients present with advanced disease. Both socioeconomic factors and tumor characteristics are associated with survival.
原发性鼻腔鼻窦黏液表皮样癌（SN-MEC）是一种源自鼻腔和鼻窦浆液黏液腺的恶性肿瘤。由于其罕见性，很少有大规模的研究。在这项研究中，我们利用国家癌症数据库（NCDB）描述了 SN-MEC 患者的发病率和生存决定因素。
这是一项回顾性的基于人群的队列研究，研究对象是 2004 年至 2012 年期间在 NCDB 中诊断为 SN-MEC 的患者。主要观察终点是总生存期（OS）。
共确定了 164 名患者。该队列由 47.6%的男性组成。诊断时的平均年龄为 59.7 岁。上颌窦是最常见的原发部位，占 45.7%的病例。11%的患者出现淋巴结疾病，而 2.1%的患者出现远处转移。30.4%的患者为 IV 期疾病。共有 79.8%的患者接受了手术，61.0%的患者接受了放疗，15.1%的患者接受了化疗。1、2 和 5 年的 OS 分别为 83%、77.0%和 57%。多变量分析显示，医疗补助保险状态（危险比[HR]，7.29；95%置信区间[CI]，1.74-30.57）、肿瘤较大（HR，4.94；95%CI，1.19-20.5）和淋巴结疾病进展（N1：HR，9.48；95%CI，1.66-54.23；N2B：HR，19.3；95%CI，1.07-350.64）与较差的 OS 相关。
黏液表皮样癌是最常见的唾液腺恶性肿瘤，但也是一种罕见的鼻腔鼻窦恶性肿瘤，SN-MEC 的 5 年生存率约为 50%。相当一部分患者存在晚期疾病。社会经济因素和肿瘤特征均与生存相关。
