{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:36:03Z","timestamp":1790012163977,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Mucoepidermoid carcinoma (MEC) is the most common malignancy of the parotid gland, but the outcome depends on the histological grade. Therefore, the aim of this study was to evaluate MEC on the basis of histological grade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective analysis of data from patients whose initial treatment for MEC of the parotid gland was performed at our department between 1999 and 2021. We examined the association between the Armed Forces Institute of Pathology (AFIP) grade and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The AFIP grades were as follows: low, 26 cases; intermediate, 9 cases; and high, 31 cases. About 50% of cases were correctly diagnosed as malignant, and both grade and histology were accurately determined by fine\u2010needle aspiration cytology in 20% of cases. The 5\u2010year disease\u2010free survival rate was 95.5% and 53.8% in the low\u2010\/intermediate\u2010 and high\u2010grade cases, respectively. In the high\u2010grade group, cases with recurrence were found to have a higher rate of lymph nodes metastasis than cases without recurrence. Furthermore, in this high\u2010grade group, total sacrifice of the facial nerve did not reduce local recurrence. However, radical resection in the cases without tumor invasion to the nerve has decreased the local recurrence rate. The CRTC1\u2010MAML2 fusion gene was expressed in 42.3% of low\u2010\/intermediate\u2010 and 14.3% of high\u2010grade cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The survival rate in MEC was quite different between the low\u2010\/intermediate\u2010 and high\u2010grade cases. However, the rate of correct assessment of the grade by fine\u2010needle aspiration cytology was poor. In high\u2010grade cases, total sacrifice of the facial nerve may improve the rate of local recurrence in cases without invasion of the main trunk of the nerve. Expression of the CRTC1\u2010MAML2 fusion gene could be helpful in not only the assessment of grade but the prediction of recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.809","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T08:48:44Z","timestamp":1653122924000},"page":"766-773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Management and outcome of parotid mucoepidermoid carcinoma by histological grade: A 21\u2010year review"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7379-5065","authenticated-orcid":false,"given":"Masataka","family":"Taniuchi","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2427-8122","authenticated-orcid":false,"given":"Ryo","family":"Kawata","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Terada","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Higashino","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Kurisu","sequence":"additional","affiliation":[{"name":"Department of Pathology Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Department of Pathology Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Hirose","sequence":"additional","affiliation":[{"name":"Department of Pathology Osaka Medical and Pharmaceutical University  Takatsuki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10006-012-0350-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70323-2"},{"key":"e_1_2_8_4_1","first-page":"159","volume-title":"WHO Classification of Head and Neck Tumors. 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