{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:40:43Z","timestamp":1786372843372,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate clinical outcome of low (G1), intermediate (G2), and high\u2010(G3) grade mucoepidermoid carcinomas (MEC) of the parotid gland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review including 212 patients. Clinicopathological data was statistically analyzed regarding grading, overall survival (OS), disease\u2010free survival (DFS) and disease\u2010specific survival (DSS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>105 (49.5%) G1, 73 (34.5%) G2, and 34 (16%) G3 MEC were included and 56 (26.4%) patients presented with neck node metastases. The risk of occult nodal metastases was significantly associated with grading and increased from 9.2% in G1 to 26.7% and 27.8% in G2 and G3 tumors, respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.008). Elective periparotid and cervical lymph node dissection was performed in 170 (80.2%) and 70 (33%) patients, respectively. All patients with positive periparotid nodes when subjected to an additional neck dissection had associated cervical neck node involvement (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Grading was an independent significant prognostic factor for OS (HR 4.05; 95%CI: 1.15\u201314.35; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.030) and DSS (HR 17.35; 95%CI: 1.10\u2013273.53; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.043). In a subgroup analysis, elective neck dissection (END) was also significantly associated with a better DFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.041) in neck node\u2010negative G1 MECs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The risk of occult nodal metastasis in intermediate\u2010grade MEC is as high as in high\u2010grade MEC and that END in G1 tumors is associated with a prolonged DFS. Additionally, periparotid node involvement seems to be a predictor for positive neck node involvement. This study presents some preliminary data to consider END in clinically neck node negative patients with parotid MEC; however, larger series are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 133:124\u2013132, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30135","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T09:25:45Z","timestamp":1651051545000},"page":"124-132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Influence of Grading on Management and Outcome in Mucoepidermoid Carcinoma of the Parotid\u2014A Multi\u2010institutional Analysis"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9523-7489","authenticated-orcid":false,"given":"Stefan","family":"Grasl","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and 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Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Pammer","sequence":"additional","affiliation":[{"name":"Clinical Department of Pathology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Weinreb","sequence":"additional","affiliation":[{"name":"Department of Pathology University Health Network, Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Karl Landsteiner University Hospital  Krems Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Princess Margaret Cancer Centre, University of Toronto  Toronto Ontario 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