Epithelial–myoepithelial carcinoma of the maxillofacial and sinonasal region: a systematic review of presenting characteristics, treatment modalities, and associated outcomes

Wockner, R.S., Seethala, R.R., Emeto, T.I., McCaul, J.A., and Subramaniam, S.S. (2022) Epithelial–myoepithelial carcinoma of the maxillofacial and sinonasal region: a systematic review of presenting characteristics, treatment modalities, and associated outcomes. International Journal of Oral and Maxillofacial Surgery. (In Press)

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Abstract

Epithelial–myoepithelial carcinoma (EMC) is a rare salivary gland malignancy. Controversy exists in the literature regarding the effectiveness of treatment modalities employed in the management of EMC. This systematic review was undertaken to understand the presenting characteristics of EMC and identify the most common treatment modalities and their associated outcomes, in order to help guide an evidenced-based approach to the algorithm of care. The MEDLINE (PubMed) and Embase databases were searched (up to February 23, 2022), and the review was performed in accordance with the PRISMA statement. Fifty-seven studies (51 case reports and six case series) describing 91 cases of EMC were included in this review. In the included studies, a slow-growing painless mass was the most common presenting clinical feature. EMC was most frequently treated with surgery alone (65%). Local disease recurrence occurred in 24% of the cases and metastatic disease in 11%. A positive surgical margin was found to be associated with a higher risk of recurrence (P < 0.001), while adjuvant radiotherapy was associated with a decreased risk of local disease recurrence (P = 0.034). Metastatic disease and multimodal therapy were found to be associated with decreased disease-free and overall survival (all P < 0.05). The current literature supports surgery with clear margins as the mainstay of treatment for EMC of the salivary and seromucous glands of the head and neck. In certain situations, radiotherapy may improve disease-free survival.

Item ID: 74375
Item Type: Article (Research - C1)
ISSN: 1399-0020
Keywords: Salivary gland neoplasms, Head and neck cancer, Mouth neoplasms, Radiotherapy, Salivary glands
Copyright Information: © 2022 Published by Elsevier Inc. on behalf of International Association of Oral and Maxillofacial Surgeons.
Date Deposited: 07 Jun 2022 00:15
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321102 Cancer diagnosis @ 40%
49 MATHEMATICAL SCIENCES > 4905 Statistics > 490502 Biostatistics @ 30%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321104 Cancer therapy (excl. chemotherapy and radiation therapy) @ 30%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 60%
20 HEALTH > 2004 Public health (excl. specific population health) > 200407 Health status (incl. wellbeing) @ 40%
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