Anatomic-sex interaction effects and prognostic stratification in mucoepidermoid carcinoma of the oral cavity minor salivary glands

Q: What study question does the paper address?

The study examines how anatomic-sex interaction effects modify survival outcomes in mucoepidermoid carcinoma of the oral cavity minor salivary glands.

Q: What data and design are used?

A retrospective cohort study uses the SEER database (2000–2021) and analyzes 923 MEC cases with stratification into four anatomic subsites.

Q: What is the main finding about sex-specific mortality risk?

Adjusted Cox models indicate males have a higher overall mortality risk, but subsite-specific analyses show paradoxical risk reductions for males in Palate_other and Other_oral compared with females.

Sep 30, 2026

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Retrospective cohort analysis investigates how anatomic-sex interactions influence survival outcomes in mucoepidermoid carcinoma (MEC) of the oral cavity minor salivary glands. Using the SEER database (2000–2021), 923 cases are stratified across palate and oral subsites and assessed with Kaplan–Meier survival curves, chi-square-based residual testing, and multivariable Cox proportional hazards models. Results show subsite-specific survival differences and sex-dependent anatomic distributions, with paradoxical mortality risk reductions for males in Palate_other and Other_oral; a risk-stratified follow-up protocol is proposed.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Background

Study aims and clinical gap

Methods

Data source and case stratification

Statistical analyses

Results

Overall survival by subsite

Sex-dependent anatomic distribution

Anatomic-sex interaction and mortality risk

Bootstrap validation

Conclusion

Proposed follow-up protocol

Zheng et al. Discover Oncology (2026) 17:24 [https://doi.org/10.1007/s12672-025-04212-5](https://doi.org/10.1007/s12672-025-04212-5) Discover Oncology ANALYSIS Open Access Anatomic-sex interaction effects and prognostic stratification in mucoepidermoid carcinoma of the oral cavity minor salivary glands Hongya Zheng 1,2, Lin He2,3, Yue Song 1,2, Shuang Zhao 1,2, Shuang Pan 1,4 and Shuang Zhang 1,4* *Correspondence: Shuang Zhang [happyzs2012@163.com](happyzs2012@163.com)[ ](happyzs2012@163.com)1Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, Harbin, China 2School of Stomatology, Harbin Medical University, Harbin, China 3Nangang Branch Department of Stomatology, Heilongjiang Provincial Hospital, Harbin, China 4NHC Key Laboratory of Cell Transplantation, The First Affiliated Hospital of Harbin Medical University, Harbin, China Abstract Background To investigate the impact of anatomic-sex interaction effects on survival outcomes in mucoepidermoid carcinoma (MEC) of the oral cavity minor salivary glands. Methods A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database (2000–2021) analyzed 923 MEC cases. Cases were stratified into four anatomic subsites: Palate, Lateral_oral, Palate_other, and Other_oral. Kaplan-Meier survival analysis, standardized residual testing via chi-square tests, and multivariable Cox proportional hazards models were employed to assess anatomic-sex interactions. A risk-stratified follow-up protocol was proposed. Results The 5-and 10-year overall survival (OS) rates were 94. 7% and 92. 6%, respectively. 1. Significant OS differences across subsites (Log-rank p = 0 . 001): Palate_other demonstrated the highest 10-year OS (96 . 8%), while Other_oral had the lowest (85 . 0%) . 2. Sex-dependent anatomic distribution (χ²(3) = 20 . 873, p < 0. 001; Cramer’s V = 0 . 15): Males predominated in the Palate subsite (44 . 1% vs. 30. 6%, Z = 4 . 20, p < 0. 001), whereas females were overrepresented in Lateral_oral (29 . 5% vs. 21.4%, Z = 2. 75) and Palate_other (18 . 2% vs. 12. 8%, Z = 2 . 19, p < 0. 05) . 3. Anatomic-sex interaction: Adjusted multivariable Cox models revealed males had 7. 01-fold higher mortality risk overall (HR = 7 . 01, 95% CI 1.50–32. 78, p = 0 . 013) . However, subsite-specific risks diverged: Palate_other males: 72% risk reduction vs. females (product-term HR = 0 . 28, p = 0 . 017);Other_oral males: 23% risk reduction vs. females (product-term HR = 0 . 77, p = 0 . 013) . 4. Bootstrap validation confirmed anatomic risk stratification (median survival: Palate_other 109.0 months vs. Palate 76.0 months, p = 0 . 003) . Conclusion Prognosis of oral cavity minor salivary gland MEC is significantly modulated by anatomic-sex interactions. Males exhibited paradoxically reduced mortality risks in Palate_other and Other_oral subsites compared to females. Sexspecific anatomic clustering was observed: males predominantly clustered in the hard palate, whereas females showed predilection for the buccal mucosa/retromolar area and soft palate. A follow-up protocol stratified by anatomic subsites was proposed to optimize clinical surveillance. Keywords Mucoepidermoid carcinoma, Anatomical site, Sex, Prognosis, Risk factors © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a cred

FAQs

What study question does the paper address?

The study examines how anatomic-sex interaction effects modify survival outcomes in mucoepidermoid carcinoma of the oral cavity minor salivary glands.

What data and design are used?

A retrospective cohort study uses the SEER database (2000–2021) and analyzes 923 MEC cases with stratification into four anatomic subsites.

What is the main finding about sex-specific mortality risk?

Adjusted Cox models indicate males have a higher overall mortality risk, but subsite-specific analyses show paradoxical risk reductions for males in Palate_other and Other_oral compared with females.

Sep 30, 2026

Upload by Rhys