UNASSIGNED: Salivary gland tumors are rare and clinically represent a diverse group of neoplasms among which mucoepidermoid carcinoma (MEC) is a relatively common salivary gland tumor with varying potential for aggressive behavior. The purpose of the study was aimed at to analyze the relative frequency and correlate with age, sex, anatomical site and histological grade of MEC and compare the findings with epidemiological data from different geographic locations.
UNASSIGNED: Twenty-five cases diagnosed with MEC during the period June 1985 to June 2004 (19 years) were retrieved from the Department of Pathology, Government Medical College and Hospital, Ambajogai, and clinical data were recorded and reviewed histopathologically.
UNASSIGNED: The relative frequency of MEC was 13.15%. Low-grade MEC (44%) was the most common, followed by intermediate-grade MEC (36%) and high-grade MEC (20%). The mean age for occurrence of MEC was 44.28 ± 13.29 years. MEC was predominant in females (60%) than males (40%). Thus, the overall female-male ratio was 1.5:1. Among minor salivary glands, palate (48%) was the most common site, and among major salivary glands, parotid gland (16%) was the common site.
UNASSIGNED: Comparing the present data with previous studies on MEC, one may infer that some demographic characteristics and the predominance vary in different geographic regions. Analysis of the distribution and particular features of MEC in a specific population helps in establishment of appropriate treatment.

BACKGROUND: Currently, the clinicopathological characteristics and prognosis of myoepithelial carcinoma of salivary gland (MC-SG) have not been defined well. The present study aimed to describe the clinicopathological characteristics and prognosis of MC-SG patients.
METHODS: The Surveillance, Epidemiology, and End Results database was searched for all patients diagnosed with MC-SG between 1991 and 2016. The Kaplan-Meier method and log-rank tests were used to evaluate the survival. Univariate and multivariate Cox regression analysis were used to identify prognostic biomarkers for overall survival (OS) and disease-specific survival (DSS). Furthermore, a prognostic nomogram was established, and its predictive accuracy and discriminative ability were determined using the concordance index (C-index).
RESULTS: In total, 245 patients diagnosed with MC-SG were identified. The median OS was 152.0 months, with 3-, 5-, and 10-year survival rates of 79.8%, 69.2%, and 50.3%. The 3-, 5-, and 10-year DSS rates were 82.5%, 77.1%, and 61.9%, respectively. Regarding the treatment regimen, most patients (92.2%) underwent surgery, and 103 patients (42.4%) received postoperative radiotherapy. Surgery could significantly prolong OS and DSS (p < .05), but postoperative radiotherapy did not significantly prolong OS and DSS when compared with individuals receiving surgery alone (p > .05). Multivariate Cox analysis revealed that T category (T4), lymph node metastasis (N2), distant metastasis (M1), and poor differentiation were independent unfavorable prognostic factors for OS and DSS. Older age (>62 years) was also independently associated with OS. In addition, the C-index for the established OS- and DSS-specific nomogram was 0.80 (95% CI: 0.72-0.88) and 0.82 (95% CI: 0.73-0.90).
CONCLUSIONS: Age, tumor invasion, metastases, and pathological grade were independently associated with prognosis of MC-SG patients, and the prognostic nomogram of this rare disease was established.

BACKGROUND: Despite modern treatment techniques, radiotherapy (RT) in patients with head and neck cancer (HNC) may be associated with high rates of acute and late treatment-related toxicity. The most effective approach to reduce sequelae after RT is to avoid as best as possible healthy tissues and organs at risk from the radiation target volume. Even small geometric changes can lead to a significant dose reduction in normal tissue and better treatment tolerability. The major objective of the current study is to investigate 3D printed, tooth-borne tissue retraction devices (TRDs) compared to conventional dental splints for head and neck RT.
METHODS: In the current two-arm randomized controlled phase II trial, a maximum of 34 patients with HNC will be enrolled. Patients will receive either TRDs or conventional dental splints (randomization ratio 1:1) for the RT. The definition of the target volume, modality, total dose, fractionation, and imaging guidance is not study-specific. The primary endpoint of the study is the rate of acute radiation-induced oral mucositis after RT. The quality of life, local control and overall survival 12 months after RT are the secondary endpoints. Also, patient-reported outcomes and dental status, as well as RT plan comparisons and robustness analyzes, will be assessed as exploratory endpoints. Finally, mesenchymal stem cells, derived from the patients\' gingiva, will be tested in vitro for regenerative and radioprotective properties.
CONCLUSIONS: The preliminary clinical application of TRD showed a high potential for reducing acute and late toxicity of RT in patients with HNC. The current randomized study is the first to prospectively investigate the clinical tolerability and efficacy of TRDs for radiation treatment of head and neck tumors.
BACKGROUND: ClinicalTrials.gov; NCT04454697; July 1st 2020; https://clinicaltrials.gov/ct2/show/record/NCT04454697 .

UNASSIGNED: The purpose of this study was to elucidate the clinicopathological characteristics of patients with lymphoepithelial carcinoma of salivary gland (LEC-SG) and determine the factors associated with survival.
UNASSIGNED: A total of 179 LEC-SG patients from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 to 2016 were included. The clinicopathological characteristics and overall survival of LEC-SG patients were described, and the features affecting prognosis were further determined using Kaplan-Meier Curves and Cox survival analysis.
UNASSIGNED: The median overall survival of LEC-SG patients was 206 months, and the 1-, 5-, 10- and 20-year survival rates were 91.0%, 80.2%, 66.4%, and 37.6%, respectively. The prognoses were significantly associated with age, ethnicity, marital status, tumor invasion, as well as lymph node metastases [P<0.01 for all). Surgical resection could significantly improve the prognosis of this disease (median overall survival (mOS): 219 vs. 68 months, P<0.01]. Postoperative radiotherapy could improve long-term survival and decrease the risk of death among patients who survive exceed 10-year after surgery. The Cox regression analysis showed that old age (>60 years) and lymph node metastases were independently associated with poor survival (P<0.05 for both). Conversely, the use of surgery was an independent favorable prognostic factor [hazard ratio (HR) 0.29, 95% CI: 0.13-0.66].
UNASSIGNED: LEC-SG patients had a favorable prognosis with a mOS of 206 months. Old age, lymph node metastases, the use of surgery were independently associated with survival of LEC-SG patients.

Myoepithelial neoplasms are rare tumors of the salivary glands with predominant myoepithelial differentiation and a broad histologic spectrum. Their histological features, immunohistochemical profile and biological behavior are not well characterized and pose a diagnostic challenge. A total of 15 myoepithelial tumors, diagnosed during 2012 and 2019 were subcategorized and correlated with MIB-1 labeling index (LI) and various histological parameters. Immunohistochemical stains for MIB-1 and other antibodies were performed. Statistical analysis was done by chi-square test, Fisher\'s exact test and Kaplan Meier curve. Nine patients were male and six were female with the median age of 44 years (range 21-83 years). Of the 15 patients, 6 cases were classified as myoepithelioma (ME) and 9 cases as myoepithelial carcinoma (MECA). Parotid gland was the most common site (46.7%) followed by the palate. MEs showed well circumscribed tumor borders whereas MECAs exhibited focal capsular to extensive invasion into adjacent tissues. Epithelioid cell morphology was most common followed by mixed cell morphology. MIB-1 LI was significantly associated with invasive tumor borders, necrosis and high mitosis. Increased frequency of recurrence was noted with high MIB-1 LI, though it was not statistically significant. MIB-1 LI was high in nearly all MECAs with focal capsular to extensive invasion while low in MEs. Myoepithelial tumor with multinodular growth pattern and focal capsular invasion may have an indolent behavior if mitotic activity and MIB-1 LI is low. Early diagnosis and treatment of MECAs significantly improves the patient\'s survival and prognosis.

OBJECTIVE: For invasive breast cancer (IBC), high SOX10 expression was reported particularly in TNBC. This raised the possibility that SOX10 may complement other breast markers for determining cancers of breast origin.
METHODS: Here, we compared the expression of SOX10 with other breast markers (GATA3, mammaglobin and GCDFP15) and their combined expression in a large cohort of IBC together with nodal metastases. We have also evaluated the expression of GATA3 and SOX10 in a wide spectrum of non-breast carcinomas to assess their value as breast specific markers.
RESULTS: Compared with other markers, SOX10 showed lower overall sensitivity (6.5%), but higher sensitivity in TNBC (31.4%) than other breast markers including GATA3 (29.7% for TNBC). Its expression demonstrated the highest concordance between the paired IBC and nodal metastases (96.4%, κ = 0.663) among all the breast markers. More importantly, SOX10 identified many GATA3-negative TNBC, thus the SOX10/GATA3 combination was the most sensitive marker combination for IBC (86.6%). For non-breast carcinoma, a high SOX10/GATA3 expression rate was found in melanoma (77.9%, predominately expressed SOX10), urothelial carcinoma (82.0%, predominately expressed GATA3) and salivary gland tumors (69.4%). Other carcinomas, including cancers from lungs, showed very low expression for the marker combination.
CONCLUSIONS: The data suggested that SOX10/GATA3 combination can be used for differentiating metastases of breast and multiple non-breast origins. However, the differentiation with melanoma and urothelial tumors required more careful histologic examination, thorough clinical information and additional site-specific IHC markers. For salivary gland tumors, the overlapping tumor types with IBC renders the differentiation difficult.

UNASSIGNED: Salivary gland tumor (SGT) is a rare disease with a largely unknown etiology. The risks of betel quid chewing, alcohol drinking, and cigarette smoking have been well documented in oral cancer but not in SGT. We aimed to investigate the independent and combined effects of betel quid chewing, cigarette smoking, and alcohol consumption on the incidence of SGT.
UNASSIGNED: We conducted a case-control study of 1845 patients aged 35-65 years, including 239 patients with pathologically proven SGT and 1606 controls from the health examination clinics of the same hospital during 2005-2014 to examine the association of these three risk factors with SGT in Taiwan. Adjusted odds ratio (aOR) and their 95% confidence interval for the association of risk factors to SGT were analyzed.
UNASSIGNED: After adjusting for covariates, aOR of cigarette smoking, alcohol drinking, and betel quid chewing were 2.50, 1.27, and 3.38, respectively for SGT. The significantly increased risk for SGT was observed in cigarette smoking (P < 0.001). Cigarette smoking was also found to increase risks in subgroups of SGT (aOR = 5.24, 2.41, 2.63, and 2.04 in minor, major, benign, and malignant SGT, respectively).
UNASSIGNED: Our study provided the first evidence to show the independent and combined impact of betel quid chewing with cigarette smoking and alcohol drinking on the SGT, and support the concept that cigarette smoking may associate with SGT carcinogenesis.

Mobile phones (MPs) are the most relevant source of radiofrequency electromagnetic field (RF-EMF) exposure to the brain and the salivary gland. Whether this exposure implies a cancer risk has been addressed in several case-control and few cohort studies. A meta-analysis of these studies does not show increased risks for meningioma, pituitary, and salivary gland tumors. For glioma and acoustic neuroma, the results are heterogeneous, with few case-control studies reporting substantially increased risks. However, these elevated risks are not coherent with observed incidence time trends, which are considered informative for this specific topic owing to the steep increase in MP use, the availability of virtually complete cancer registry data from many countries, and the limited number of known competing environmental risk factors. In conclusion, epidemiological studies do not suggest increased brain or salivary gland tumor risk with MP use, although some uncertainty remains regarding long latency periods (>15 years), rare brain tumor subtypes, and MP usage during childhood.

UNASSIGNED: Pulmonary mucoepidermoid carcinoma (PMEC) and pulmonary adenoid cystic carcinoma (PACC) are the two major types of primary salivary gland-type (PSGT) lung cancers. The demographic profile, clinicopathological features, and predictors of survival as an overall group have not been described for PSGT cancers of lung.
UNASSIGNED: In this study, we analyzed demographic, clinical, and survival data from 1,032 patients (546 PMEC and 486 PACC) who were diagnosed of PSGT lung cancer in the Surveillance, Epidemiology and End Results database from 1973 to 2014.
UNASSIGNED: The PSGT constituted 0.09% of all lung cancers with age-adjusted incidence rate of 0.07 per 100,000 person-years and change of -32% from 1973 to 2014. The incidence of PMEC was slightly higher than PACC but there were no differences in the age and sex distribution. PACCs (55%) were significantly higher at trachea and main bronchus while PMECs were more common at peripheral lungs (85%). Most of the tumors were diagnosed at an early stage and were low grade irrespective of histology. As compared to PMEC, significantly higher number of patients with PACC underwent radical surgery and received adjuvant radiation. The 1- and 5-year cause-specific survival was 76.6 and 62.8%, respectively. On multivariate analysis, the survival was affected by age at diagnosis, tumor stage, histological grade, period of diagnosis, and surgical resection. The histology showed strong interaction with time and hazard ratio of patients with PACC was significantly worse than patients with PMEC only after 5 years.
UNASSIGNED: The incidence of pulmonary PSGT cancer is 7 cases per 10 million population in the United States and is decreasing. There was no difference between demographic profile of patients with PMEC and PACC but pathological features were diverse. The difference in the survival of patients with the two histological types surfaced only after 5 years when survival of patients with PMEC was better than PACC.

OBJECTIVE: To improve the diagnoses of the salivary gland tumors, a dynamic-enhanced MRI (dMRI) was investigated.
METHODS: We conducted a retrospective chart review of 93 cases of salivary gland tumors. The histological diagnoses were obtained from all patients using a surgical specimen and/or an open biopsy specimen. The dMRI as well as fine-needle aspiration cytology (FNAC) and intraoperative frozen section (IFS) were analyzed. This study focused on the time-intensity curve (TIC) after injection, peak time (Tpeak), washout ratio (WR) as well as the gradient of enhancement and washout profile.
RESULTS: The histological diagnoses included pleomorphic adenoma (PMA) in 53 cases, the Warthin tumors (WT) in 14 cases and malignant tumors (MT) in 26 cases. Incorrect diagnosis rate of FNAC and IFS were 5.2 and 8.3%, respectively. The TIC revealed differences among the three types of tumors. Tpeak as well as WR also revealed significant differences (p < 0.001). Tpeak were lower in order of WT, MT, PMA, respectively. WR of TICs at 30, 45 and 105 s after Tpeak were higher in order of WT, MT, PMA, respectively (p < 0.001). The gradient of increment and washout in the TIC curve was also an important parameter to distinguish the three types of tumors. In MT, the rapid enhancement pattern was found in high or intermediate histological grade tumors, whereas the slow enhancement pattern was exhibited in low grade tumors.
CONCLUSIONS: Our findings indicate that using Tpeak and WR, it is possible to distinguish between WT, PMA and MT. Additionally, a rapid enhancement pattern may be a potential marker for these tumors.