Comparative impact of grade on mortality across salivary cancers: A novel, unifying staging system-Reference-Cited by-同舟云学术

Comparative impact of grade on mortality across salivary cancers: A novel, unifying staging system

Published:2023-06-22 Issue:8 Volume:45 Page:2028-2039
ISSN:1043-3074
Container-title:Head & Neck
language:en
Short-container-title:Head & Neck

Author:

Ho Allen S.¹²^ORCID,Luu Michael¹³,Balzer Bonnie L.¹⁴,Aro Katri⁵^ORCID,Jang Julie K.¹⁶,Mita Alain C.¹⁷,Scher Kevin S.¹⁷,Mallen‐St. Clair Jon¹²^ORCID,Vasquez Missael²,Bastien Amanda J.²^ORCID,Epstein Joel B.¹,Lin De‐Chen⁸,Chen Michelle M.¹²,Zumsteg Zachary S.¹⁶^ORCID

Affiliation:

1. Samuel Oschin Comprehensive Cancer Institute Helsinki University Hospital, University of Helsinki Helsinki Finland

2. Division of Otolaryngology – Head and Neck Surgery, Department of Surgery Helsinki University Hospital, University of Helsinki Helsinki Finland

3. Biostatistics and Bioinformatics Research Center Helsinki University Hospital, University of Helsinki Helsinki Finland

4. Department of Pathology Helsinki University Hospital, University of Helsinki Helsinki Finland

5. Department of Otorhinolaryngology – Head and Neck Surgery Helsinki University Hospital, University of Helsinki Helsinki Finland

6. Department of Radiation Oncology Cedars‐Sinai Medical Center Los Angeles California USA

7. Division of Medical Oncology, Department of Medicine Cedars‐Sinai Medical Center Los Angeles California USA

8. Herman Ostrow School of Dentistry University of Southern California, Cedars‐Sinai Medical Center Los Angeles California USA

Abstract

AbstractBackgroundThe comparative impact of histologic variants and grade has not been well described.MethodsSalivary cancer histologies were profiled using hospital and population‐based cancer registries. Multivariable models were employed to assess relationships between histology, grade, and survival.ResultsOn 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).ConclusionGrade represents a primary determinant of salivary cancer prognosis. Integrating grade into stage strengthens current staging systems.

Publisher

Wiley

Subject

Otorhinolaryngology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1002/hed.27429

Reference41 articles.

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1. Reply to Letter to the Editor: Should there be a definite place for grade in the next TNM staging system for (major) salivary gland malignancies?;Head & Neck;2023-08-31

2. Should there be a definite place for grades in the next TNM staging system for (major) salivary gland malignancies?;Head & Neck;2023-08-30