Prognostic analysis and nomogram establishment in patients with head and neck myoepithelial carcinoma

Abstract

Purpose: To further explore the clinicopathological characteristics and determinants of survival of patients with HNMC.

Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to collect the data of patients diagnosed with HNMC from 1975 to 2016. Kaplan-Meier analysis and log-rank testing compared the survival difference. Cox hazard regression models analyzed the survival outcome and prognostic factors. Concordance index (C-index) verified the nomogram.

Results: A total of 322 eligible cases were retrieved. The mean age at diagnosis was 61 years old and the male to female ratio was 1:1. The major salivary gland was the most common primary site (72.5%). Patients with adjuvant radiation showed better overall survival (OS) (P < 0.05). Advanced grade, N, M stage and nonsurgery contributed independently to shorter OS, while the advanced N, M stage and nonsurgery contributed independently to shorter disease-specific survival (DSS) (P < 0.05). The C-index of OS-specific nomogram was 0.768 (95% CI 0.726-0.810).

Conclusions: HNMC usually appears in elderly patients and has no gender difference. The 5-year OS and DSS rates are 70% and 79.8%, respectively. Grade, N, M stage and surgery are independent prognostic factors for OS, while N, M stage and surgery are independent prognostic factors for DSS. Compared with the surgery alone, adjuvant radiation appears to offer a significant OS benefit for patients with stage III or IV.

Keywords: Head and neck; Myoepithelial carcinoma; Prognosis; SEER database.