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Purpose <p>Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor, yet prognosis may vary substantially by tumor site. While prior studies emphasized head and neck sites, the impact of anatomic location across both conventional (major and minor salivary gland) and unconventional sites remains poorly defined.</p> Methods <p>Using the Surveillance, Epidemiology, and End Results (SEER) 21 database (2000–2022), we identified adults with histologically confirmed MEC. Demographic, clinicopathologic, treatment, and survival patterns were compared across major anatomic site groups. Cause-specific survival (CSS) was estimated with Kaplan–Meier methods, and multivariable Cox regression assessed predictors of death adjusting for age, tumor grade, and treatment.</p> Results <p>Among 15,556 MEC cases, 90% arose in the major or minor salivary glands, most commonly the parotid gland (50% of all MEC). Unconventional sites included lung/bronchus (6%), and at least 100 cases each in eye/orbit, thyroid/thymus, and skin (&lt; 1%). Age, grade, nodal status, and stage varied by site; nodal metastases were highest in eye/orbit (57%), and distant disease most frequent in thyroid/thymus (19%) and lung/bronchus (16%). Ten-year CSS exceeded 96% for most localized MEC but was lower in localized eye/orbit tumors (81%). Regional and distant disease showed worse outcomes, especially in lung/bronchus (10-year CSS, 71% and 9%). Older age, high grade, and lack of surgery independently predicted worse survival.</p> Conclusion <p>Tumor site of origin is a major determinant of prognosis for patients with MEC. In addition to stage and grade, incorporating anatomic site into risk stratification may improve prognostic precision, inform treatment decisions, and support the development of site-tailored guidelines.</p>

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Prognostic Role of Unconventional Tumor Site of Origin in Mucoepidermoid Carcinoma: A Comprehensive Analysis Using the SEER Database

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Fatma Cemre Sazak Kundi,
  • Erich M. Sturgis,
  • Ray Y. Wang,
  • Kristina R. Dahlstrom

摘要

Purpose

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor, yet prognosis may vary substantially by tumor site. While prior studies emphasized head and neck sites, the impact of anatomic location across both conventional (major and minor salivary gland) and unconventional sites remains poorly defined.

Methods

Using the Surveillance, Epidemiology, and End Results (SEER) 21 database (2000–2022), we identified adults with histologically confirmed MEC. Demographic, clinicopathologic, treatment, and survival patterns were compared across major anatomic site groups. Cause-specific survival (CSS) was estimated with Kaplan–Meier methods, and multivariable Cox regression assessed predictors of death adjusting for age, tumor grade, and treatment.

Results

Among 15,556 MEC cases, 90% arose in the major or minor salivary glands, most commonly the parotid gland (50% of all MEC). Unconventional sites included lung/bronchus (6%), and at least 100 cases each in eye/orbit, thyroid/thymus, and skin (< 1%). Age, grade, nodal status, and stage varied by site; nodal metastases were highest in eye/orbit (57%), and distant disease most frequent in thyroid/thymus (19%) and lung/bronchus (16%). Ten-year CSS exceeded 96% for most localized MEC but was lower in localized eye/orbit tumors (81%). Regional and distant disease showed worse outcomes, especially in lung/bronchus (10-year CSS, 71% and 9%). Older age, high grade, and lack of surgery independently predicted worse survival.

Conclusion

Tumor site of origin is a major determinant of prognosis for patients with MEC. In addition to stage and grade, incorporating anatomic site into risk stratification may improve prognostic precision, inform treatment decisions, and support the development of site-tailored guidelines.