Sinonasal Mucoepidermoid Carcinoma: A Review of the National Cancer Database

Vasiliki Triantafillou 1, Ivy W Maina 1, Edward C Kuan 2, Michael A Kohanski 1, Charles C Tong 1, Neil N Patel 1, Ryan M Carey 1, Alan D Workman 1, James N Palmer 1, Nithin D Adappa 1, Jason A Brant 1

Affiliations 

Affiliations

• 1Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
• 2Department of Otolaryngology-Head and Neck Surgery, Irvine Medical Center, University of California, Orange, CA.

• PMID: 31314958
 
• DOI: 10.1002/alr.22379

Abstract

Background: 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).

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: NCDB; National Cancer Database; sinonasal carcinoma; sinonasal mucoepidermoid carcinoma; survival.

© 2019 ARS-AAOA, LLC.

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