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Rivista di Chirurgia
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2016 Ottobre;29(5):149-54
A clinicopathological study of mucoepidermoid carcinoma of the lung in surgical cases
Junzo SHIMIZU 1, Isao MATSUMOTO 2, Makio MORIYA 1, Tadashi KAMESUI 1, Saki HAYASHI 1, Koichiro KOBAYASHI 3, Akitaka NONOMURA 4
1 Department of Surgery, Hokuriku Central Hospital, Oyabe, Japan; 2 Department of Chest Surgery, Kanazawa University Hospital, Kanazawa, Japan; 3 Department of Chest Surgery, Toyama Red Cross Hospital, Toyama, Japan; 4 Department of Pathology, Hokuriku Central Hospital, Oyabe, Japan
BACKGROUND: Mucoepidermoid carcinoma (MEC) of the lung, which is relatively rare, has been regarded as having low-grade malignant potential. However, we often encounter cases with advanced MEC showing local invasion or distant metastasis. Here, we assessed the clinicopathological characteristics of MEC in patients undergoing surgery.
METHODS: Of 1534 lung cancer patients who underwent surgical treatment at our hospital and the associated institutes between 1990 and 2014, we enrolled 11 patients (7 men and 4 women with a mean age of 59.7 years [42-93 years]) with histologically confirmed diagnosis of MEC (0.72%). Pathological staging was IA in 2, IB in 1, IIA in 1, IIIA in 5, and IV in 2 patients. The primary tumor was classified, according to tumor localization, as central type in 6 or peripheral type in 5 patients. Operative methods included pneumonectomy in 3, lobectomy in 4, wedge resection in 2, and tracheal (or bronchial) sleeve resection in 2 patients. The histological grade was I in 5, II in 4, and III in 2 patients.
RESULTS: None of the patients were preoperatively diagnosed with MEC. According to the TMN staging, the 10-year survival rate for those with N0M0 was 100%, whereas the 3-year survival rate for those with N(+) or M(+) was 0%. According to primary tumor location, the 10-year survival rate for the central type was 66.7%, whereas the 4-year survival rate for the peripheral type was 30%. According to histological grade, the 10-year survival for grade 1 was 80% and the 4-year survival rate for grade 2 and 3 was 22%. The 10-year survival rate for female patients was 100%, whereas the 9-year survival rate for male patients was 19%. Patients with long-term survival all had a grade 1 central type tumor.
CONCLUSIONS: To optimize MEC treatment, the accuracy of preoperative diagnosis needs to be improved. Patients diagnosed with low-grade MEC should undergo lung function-preserving surgery if possible. Meanwhile, adjuvant therapy for high-grade MEC is a challenging issue.