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Background <p>To investigate the impact of anatomic-sex interaction effects on survival outcomes in mucoepidermoid carcinoma (MEC) of the oral cavity minor salivary glands.</p> Methods <p>A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database (2000–2021) analyzed 923 MEC cases. Cases were stratified into four anatomic subsites: Palate, Lateral_oral, Palate_other, and Other_oral. Kaplan-Meier survival analysis, standardized residual testing via chi-square tests, and multivariable Cox proportional hazards models were employed to assess anatomic-sex interactions. A risk-stratified follow-up protocol was proposed.</p> Results <p>The 5- and 10-year overall survival (OS) rates were 94.7% and 92.6%, respectively. 1. Significant OS differences across subsites (Log-rank <i>p</i> = 0.001): Palate_other demonstrated the highest 10-year OS (96.8%), while Other_oral had the lowest (85.0%). 2. Sex-dependent anatomic distribution (χ²(3) = 20.873, <i>p</i> &lt; 0.001; Cramer’s V = 0.15): Males predominated in the Palate subsite (44.1% vs. 30.6%, Z = 4.20, <i>p</i> &lt; 0.001), whereas females were overrepresented in Lateral_oral (29.5% vs. 21.4%, Z = 2.75) and Palate_other (18.2% vs. 12.8%, Z = 2.19, <i>p</i> &lt; 0.05). 3. Anatomic-sex interaction: Adjusted multivariable Cox models revealed males had 7.01-fold higher mortality risk overall (HR = 7.01, 95% CI 1.50–32.78, <i>p</i> = 0.013). However, subsite-specific risks diverged: Palate_other males: 72% risk reduction vs. females (product-term HR = 0.28, <i>p</i> = 0.017);Other_oral males: 23% risk reduction vs. females (product-term HR = 0.77, <i>p</i> = 0.013). 4. Bootstrap validation confirmed anatomic risk stratification (median survival: Palate_other 109.0 months vs. Palate 76.0 months, <i>p</i> = 0.003).</p> Conclusion <p>Prognosis of oral cavity minor salivary gland MEC is significantly modulated by anatomic-sex interactions. Males exhibited paradoxically reduced mortality risks in Palate_other and Other_oral subsites compared to females. Sex-specific anatomic clustering was observed: males predominantly clustered in the hard palate, whereas females showed predilection for the buccal mucosa/retromolar area and soft palate. A follow-up protocol stratified by anatomic subsites was proposed to optimize clinical surveillance.</p>

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Anatomic-sex interaction effects and prognostic stratification in mucoepidermoid carcinoma of the oral cavity minor salivary glands

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月1日

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  • Hongya Zheng,
  • Lin He,
  • Yue Song,
  • Shuang Zhao,
  • Shuang Pan,
  • Shuang Zhang

摘要

Background

To investigate the impact of anatomic-sex interaction effects on survival outcomes in mucoepidermoid carcinoma (MEC) of the oral cavity minor salivary glands.

Methods

A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database (2000–2021) analyzed 923 MEC cases. Cases were stratified into four anatomic subsites: Palate, Lateral_oral, Palate_other, and Other_oral. Kaplan-Meier survival analysis, standardized residual testing via chi-square tests, and multivariable Cox proportional hazards models were employed to assess anatomic-sex interactions. A risk-stratified follow-up protocol was proposed.

Results

The 5- and 10-year overall survival (OS) rates were 94.7% and 92.6%, respectively. 1. Significant OS differences across subsites (Log-rank p = 0.001): Palate_other demonstrated the highest 10-year OS (96.8%), while Other_oral had the lowest (85.0%). 2. Sex-dependent anatomic distribution (χ²(3) = 20.873, p < 0.001; Cramer’s V = 0.15): Males predominated in the Palate subsite (44.1% vs. 30.6%, Z = 4.20, p < 0.001), whereas females were overrepresented in Lateral_oral (29.5% vs. 21.4%, Z = 2.75) and Palate_other (18.2% vs. 12.8%, Z = 2.19, p < 0.05). 3. Anatomic-sex interaction: Adjusted multivariable Cox models revealed males had 7.01-fold higher mortality risk overall (HR = 7.01, 95% CI 1.50–32.78, p = 0.013). However, subsite-specific risks diverged: Palate_other males: 72% risk reduction vs. females (product-term HR = 0.28, p = 0.017);Other_oral males: 23% risk reduction vs. females (product-term HR = 0.77, p = 0.013). 4. Bootstrap validation confirmed anatomic risk stratification (median survival: Palate_other 109.0 months vs. Palate 76.0 months, p = 0.003).

Conclusion

Prognosis of oral cavity minor salivary gland MEC is significantly modulated by anatomic-sex interactions. Males exhibited paradoxically reduced mortality risks in Palate_other and Other_oral subsites compared to females. Sex-specific anatomic clustering was observed: males predominantly clustered in the hard palate, whereas females showed predilection for the buccal mucosa/retromolar area and soft palate. A follow-up protocol stratified by anatomic subsites was proposed to optimize clinical surveillance.