Wang Jia-Qi, Deng Rong-Xin, Liu Hui, Luo Yuan, Lu Meng-Meng, Yang Zhi-Cheng
Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
Front Oncol. 2022 Jun 30;12:754967. doi: 10.3389/fonc.2022.754967. eCollection 2022.
Malignant myoepithelioma of the head and neck (HNMM) is a rare malignancy, and its characteristics and survival rates have not been well-defined. This study aimed to define the epidemiology of HNMM and identify the prognostic factors associated with the disease. Data on all patients diagnosed with HNMM between 1991 and 2016 were gathered from the Surveillance Epidemiology and End Results (SEER) database. The demographics, clinicopathological characteristics, treatment, and prognoses of the patients were described. Cox regression analysis was used to identify the prognostic factors, and the prognostic nomograms for overall survival (OS) and disease-specific survival (DSS) were constructed. A total of 333 cases of HNMM were identified. The average age at diagnosis was 60.6 years, and 50.1% of the patients were men. After diagnosis, 46.2% of patients underwent surgery alone, 43.5% of patients underwent surgery and radiotherapy, and 3.6% of patients received only radiotherapy. Survival analysis showed that the 5-year OS and DSS for all HNMM patients were 69.7 and 82.1%, respectively. In the multivariate analysis model, the undifferentiated pathological grade (P <0.05) and M1 in the M category (P <0.01) were independent prognostic factors for poor OS and DSS, whereas the use of surgical resection was an independent favorable prognostic factor for both OS and DSS (P <0.05). The prognostic nomograms for OS and DSS prediction were constructed; the C-index values for OS and DSS prediction were 0.78 (95% CI 0.70-0.86) and 0.79 (95% CI 0.67-0.90), respectively. In conclusion, this SEER data-based study demonstrated that HNMM patients often had a favorable prognosis, and distant metastasis, pathological grade, and the use of surgery contributed to their survival. Furthermore, we developed a prognostic nomogram to predict OS and DSS for HNMM patients to aid physicians in the clinical management of this rare disease.
头颈部恶性肌上皮瘤（HNMM）是一种罕见的恶性肿瘤，其特征和生存率尚未明确界定。本研究旨在明确HNMM的流行病学特征，并确定与该疾病相关的预后因素。收集了1991年至2016年间所有诊断为HNMM患者的数据，这些数据来自监测、流行病学和最终结果（SEER）数据库。描述了患者的人口统计学特征、临床病理特征、治疗情况和预后。采用Cox回归分析确定预后因素，并构建总生存（OS）和疾病特异性生存（DSS）的预后列线图。共识别出333例HNMM病例。诊断时的平均年龄为60.6岁，50.1%的患者为男性。诊断后，46.2%的患者仅接受手术治疗，43.5%的患者接受手术和放疗，3.6%的患者仅接受放疗。生存分析显示，所有HNMM患者的5年总生存率和疾病特异性生存率分别为69.7%和82.1%。在多变量分析模型中，未分化病理分级（P<0.05）和M分期中的M1（P<0.01）是总生存率和疾病特异性生存率较差的独立预后因素，而手术切除的使用是总生存率和疾病特异性生存率的独立有利预后因素（P<0.05）。构建了总生存率和疾病特异性生存率预测的预后列线图；总生存率和疾病特异性生存率预测的C指数值分别为0.78（95%CI 0.70-0.86）和0.79（95%CI 0.67-0.90）。总之，这项基于SEER数据的研究表明，HNMM患者通常预后良好，远处转移、病理分级和手术的使用对其生存有影响。此外，我们开发了一种预后列线图来预测HNMM患者的总生存率和疾病特异性生存率，以帮助医生对这种罕见疾病进行临床管理。
