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- Title
Comparative impact of grade on mortality across salivary cancers: A novel, unifying staging system.
- Authors
Ho, Allen S.; Luu, Michael; Balzer, Bonnie L.; Aro, Katri; Jang, Julie K.; Mita, Alain C.; Scher, Kevin S.; Mallen‐St. Clair, Jon; Vasquez, Missael; Bastien, Amanda J.; Epstein, Joel B.; Lin, De‐Chen; Chen, Michelle M.; Zumsteg, Zachary S.
- Abstract
Background: The comparative impact of histologic variants and grade has not been well described. Methods: Salivary cancer histologies were profiled using hospital and population‐based cancer registries. Multivariable models were employed to assess relationships between histology, grade, and survival. Results: On univariate analysis, histologic variants exhibited a wide spectrum of mortality risk (5‐year overall survival (OS): 86% (acinic cell carcinoma), 78% (mucoepidermoid carcinoma), 72% (adenoid cystic carcinoma), 64% (carcinoma ex‐pleomorphic adenoma), 52% (adenocarcinoma NOS), and 47% (salivary duct carcinoma) (p < 0.001). However, on multivariable analysis these differences largely vanished. Worsening grade corresponded with deteriorating survival (5‐year OS: 89% [low‐grade], 81% [intermediate‐grade], 45% [high‐grade]; p < 0.001), which was upheld on multivariable analysis and propensity score matching. Recursive partitioning analysis generated TNM + G schema (c‐index 0.75) superior to the existing system (c‐index 0.73). Conclusion: Grade represents a primary determinant of salivary cancer prognosis. Integrating grade into stage strengthens current staging systems.
- Subjects
ADENOID cystic carcinoma; MUCOEPIDERMOID carcinoma; PROPENSITY score matching; RECURSIVE partitioning; UNIVARIATE analysis
- Publication
Head & Neck, 2023, Vol 45, Issue 8, p2028
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.27429