Background
Mucoepidermoid carcinoma (MEC) is a diverse salivary gland malignancy with varied prognostic outcomes. Different grading systems have been proposed, each with its complexities and merits.
Objective
This study harnesses the precision of MEC assessment by consolidating two established grading systems: AFIP and Brandwein.
 Method
We evaluated primary MEC cases (2016-2022) using four prominent grading systems: modified Healey, AFIP, Brandwein, and Katabi. An algorithm was devised to integrate these systems and derive average scores harmoniously. The impact on overall survival, disease-free measures, and recurrence was investigated.
Results
The integrated grading algorithm yielded a holistic perspective, enhancing the prognostic significance of MEC grading. Brandwein's high-grade designation emerged as a potent predictor of aggressive behavior. Our approach unveiled nuanced relationships between morphological features and outcomes, offering an avenue for targeted therapeutic decisions.
Advances in Knowledge
This study offers a novel approach to assess MECs—a unified grading system that draws strength from multiple established paradigms. By orchestrating this synergistic approach, clinicians and pathologists can navigate the complexity of MEC with enhanced precision, aiding in prognosis determination and informed therapeutic interventions.