title: Epithelial-Myoepithelial Carcinoma of the Salivary Glands: An Analysis of 246 Cases.
abstract: OBJECTIVE
  Epithelial-myoepithelial carcinoma (EMC) is a rare neoplasm of the salivary glands. In this study, we aim to examine the demographic, clinicopathologic, and survival features of EMC using a population-based approach.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Result (SEER) database (1973-2010) was queried for EMC of the major salivary glands. Data were analyzed with respect to various demographic and clinicopathologic factors. Survival was analyzed using the Kaplan-Meier and Cox proportional hazards models.
  
  
  RESULTS
  In total, 246 cases were available for frequency analysis and 207 for survival analysis. Mean ± SD age at diagnosis was 63.8 ± 15.4 years. EMC affected females more frequently (57.3%). Distant metastases were present at diagnosis in only 4.5% of cases. Overall disease-specific survival (DSS) at 60, 120, and 180 months was 91.3%, 90.2%, and 80.7%, respectively. Patients with low-grade histology had significantly better survival at 180 months relative to those with high-grade tumors (90.6% vs 0.0%, P = .0246). When stratified by tumor size, patients with lesions >4 cm had the worst survival at 180 months (58.8%, P = .0003). All but 9 of the 207 cases available for survival analysis underwent surgery. A total of 85 patients (41.1%) received radiotherapy in addition to surgery. No survival benefit was noted for patients who received radiotherapy compared with those who did not (P = .4832).
  
  
  CONCLUSIONS
  This report represents the largest series of EMC to date. Despite being regarded as a low-grade, indolent tumor, a significant fraction of our cohort underwent radiotherapy in addition to surgery, with no apparent added survival benefit.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Vázquez
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Tapan D
authors.initials: TD
authors.lastname: Patel
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: D'Aguillo
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Rami Y
authors.initials: RY
authors.lastname: Abdou
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: William
authors.initials: W
authors.lastname: Farver
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Cwp39@njms.rutgers.edu.
authors.forename: Richard Chan W
authors.initials: RC
authors.lastname: Park
mesh_terms: D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009208:Myoepithelioma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy
keywords: Surveillance, Epidemiology, and End Result (SEER) database; epidemiology; epithelial-myoepithelial carcinoma; neck cancer; occupational exposure; salivary cancer; salivary gland neoplasm, major salivary glands; sex; survival