Comparative impact of grade on mortality across salivary cancers: A novel, unifying staging system.
Head Neck
; 45(8): 2028-2039, 2023 Aug.
Article
em En
| MEDLINE
| ID: mdl-37345665
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.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Neoplasias das Glândulas Salivares
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Carcinoma Mucoepidermoide
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Carcinoma de Células Acinares
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Carcinoma Adenoide Cístico
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Adenoma Pleomorfo
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Head Neck
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Finlândia