title: A comparative analysis of sinonasal and salivary gland mucoepidermoid carcinoma using population-based data.
abstract: BACKGROUND
  Mucoepidermoid carcinoma (MEC) is the most common salivary gland (SG) malignancy. Primary sinonasal MEC (SN-MEC) is rare. This study analyzes the demographic, clinicopathologic, and survival characteristics of SN-MEC and establishes comparisons with primary major SG-MEC.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results (SEER) database (1973 to 2010) was queried for SN-MEC (149 cases) and SG-MEC (4234 cases). Data were analyzed comparatively with respect to various demographic and clinicopathologic factors. Survival was analyzed using the Kaplan-Meier and Cox proportional hazards models.
  
  
  RESULTS
  Mean ± standard deviation (SD) age at diagnosis for SN-MEC was 58.6 ± 16.6 years. High histologic grade (ie, grades III and IV) at the time of diagnosis was more common among SN-MEC than SG-MEC (42.3% vs 25.5%, p < 0.0001). Overall 5-year disease-specific survival (DSS) was 61.7% for SN-MEC and 84.1% for SG-MEC (p < 0.001). For SN-MEC, factors associated with poor prognosis were age (75+ years; hazard ratio [HR], 3.38; 95% confidence interval [CI], 1.25 to 9.51), higher tumor grade (grade III and IV; HR, 3.62; 95% CI, 1.75 to 8.22), larger tumor size (>4 cm; HR, 8.36, 95% CI, 1.59 to 153.74), and primary tumor site (ethmoid sinus; HR, 2.95; 95% CI, 1.28 to 6.23) (all p < 0.05). Survival was better among those treated with surgery (with [64.4% survival] or without [81.3% survival] adjuvant radiation therapy) than those treated with primary radiation therapy alone (25.6% survival) (p < 0.05).
  
  
  CONCLUSIONS
  This report represents the largest series of SN-MEC to date. Although SN-MEC and SG-MEC share a common histology, there are important clinical differences between the 2 conditions.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Tapan D
authors.initials: TD
authors.lastname: Patel
authors.forename: Alejandro
authors.initials: A
authors.lastname: Vázquez
authors.forename: Dhruv M
authors.initials: DM
authors.lastname: Patel
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D000367:Age Factors; D000368:Aged; D018277:Carcinoma, Mucoepidermoid / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D010256:Paranasal Sinuses / Q000473:pathology*; D044382:Population Groups; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis
keywords: SEER; mucoepidermoid carcinoma; nasal cancer; paranasal sinus neoplasm; salivary gland carcinoma; sinonasal cancer