Mucoepidermoid carcinoma (MEC) is a glandular epithelial neoplasm, characterized by squamous and mucinous cellular morphologies, that arises from secretory stem cells. While MEC is the most common malignant tumor in the salivary glands, accounting for 10–15 % of salivary gland neoplasms and 30 % of salivary malignancies, it can manifest in other head and neck structures [1], [2], [3].

Previous research examining the impact of primary tumor site on head and neck MEC survival is controversial [2], [4]. Patel et al. found that salivary gland MEC had significantly better 5-year cancer-specific survival than sinonasal MEC [9]. However, a small sample cohort study concluded that primary tumor site is not a significant independent predictor of survival or recurrence [2]. Additionally, the epidemiologic characteristics of head and neck MEC, especially the factors influencing prognosis, are not well understood. Coleman et al. performed an epidemiological analysis of major salivary gland cancers, including MEC, but this study only focused on pediatric patients while excluding adults [5]. Triantafillou et al. and Ellis et al. investigated demographic factors related to specific tumor sites, but these analyses were limited to the sinonasal cavity and the oral cavity/oropharynx, respectively [6], [7]. Furthermore, a recent study investigated the epidemiological factors of head and neck MEC between 2000 and 2015 using the Surveillance, Epidemiology, and End Results (SEER) database, but utilized a relatively small sample size of 2,692 patients and had a broader classification of the head and neck regions. However, due to SEER’s limitations, there was no available patient data regarding race, ethnicity, insurance status, or various surgical procedures. Interestingly, Gui et al. found that head and neck MEC patients who did not undergo surgery had a hazard ratio of 3.2. While surgery holds a strong influence over MEC prognosis, there is scarce literature elucidating who is more likely to undergo surgery [8]. Given varying overall survival (OS) rates for MEC, ranging from low-grade to high-grade aggressive prognoses, further research is crucial to elucidate more of the prognostic survival factors behind head and neck MEC, with the ultimate goals of expanding proactive care, improving clinical decision-making, and optimizing patient outcomes.

This study is unique in that it is the first to leverage National Cancer Database (NCDB) data in evaluating head and neck MEC demographic and prognostic factors in whole. With the larger patient population and additional demographic capabilities provided by NCDB, this study aims to provide a complete and thorough demographic analysis of all patients with MEC in the head and neck, itemized by specific primary sites, and assess how these factors influence survival.