Introduction: Major salivary gland carcinomas (MSGCs) are rare, heterogeneous malignancies with high recurrence rates. Recurrent-metastatic (RM) MSGCs frequently represent a clinical challenge due to their unpredictable behavior and the absence of established prognostic markers for the disease course of relapsed disease. Materials and methods: This multicenter retrospective study, involving 10 tertiary centers worldwide, included patients affected by loco-regional and/or distant relapse after surgery with curative intent. The study aimed to analyze residual survival (recurrent-metastatic survival, RMS) and identify key prognostic factors to support personalized treatment strategies, especially for exclusive loco-regional and distant recurrences. Results: Among 212 patients, the median disease-free interval (DFI) after the initial treatment was 14 months, with a 1-year RMS of 58.1% (95% CI, 51.6–65.6%). Longer DFI (>30 months), adenoid cystic carcinoma histology, loco-regional recurrence rather than failure at distance, and absence of nodal metastasis (pN0) at initial diagnosis were significantly associated with a better residual overall survival. In patients with exclusive loco-regional recurrence, independent positive prognostic factors included DFI, salvage surgery, primary low-grade tumor, and lower pT classification. In contrast, for patients with exclusive distant metastasis, longer DFI (>30 months) and the type of intervention (metastasectomy for oligometastatic disease) were independent prognosticators. Conclusion: Disease-free interval is a key prognostic factor for the residual overall survival after a recurrence event. Primary tumor characteristics were associated with survival outcomes in the loco-regional recurrent setting, but not if the recurrence is at distance. Whenever feasible, salvage surgery for loco-regional recurrence and metastasectomy for oligometastatic disease may be considered in highly selected patients.
Prognostic factors and survival after recurrence in major salivary gland carcinomas: a multicenter study / Tomasoni, M., Lorini, L., Ferrari, M., Missale, F., Borsetto, D., Van Lierde, C., Van Eecke, M., Di Santo, D., Mazzola, F., Hubert Low, T-H., Gupta, R., Fleming, J.C., Ghazal-Asswad, R., Nankivell, P., Galli, A., Giordano, L., Ravanelli, M., Filauro, M., Peretti, G., Bussi, M., et al.. - In: ORAL ONCOLOGY. - ISSN 1368-8375. - 178:(2026). [10.1016/j.oraloncology.2026.107979]
Prognostic factors and survival after recurrence in major salivary gland carcinomas: a multicenter study
Galli A.;Giordano L.Supervision
;Bussi M.;
2026-01-01
Abstract
Introduction: Major salivary gland carcinomas (MSGCs) are rare, heterogeneous malignancies with high recurrence rates. Recurrent-metastatic (RM) MSGCs frequently represent a clinical challenge due to their unpredictable behavior and the absence of established prognostic markers for the disease course of relapsed disease. Materials and methods: This multicenter retrospective study, involving 10 tertiary centers worldwide, included patients affected by loco-regional and/or distant relapse after surgery with curative intent. The study aimed to analyze residual survival (recurrent-metastatic survival, RMS) and identify key prognostic factors to support personalized treatment strategies, especially for exclusive loco-regional and distant recurrences. Results: Among 212 patients, the median disease-free interval (DFI) after the initial treatment was 14 months, with a 1-year RMS of 58.1% (95% CI, 51.6–65.6%). Longer DFI (>30 months), adenoid cystic carcinoma histology, loco-regional recurrence rather than failure at distance, and absence of nodal metastasis (pN0) at initial diagnosis were significantly associated with a better residual overall survival. In patients with exclusive loco-regional recurrence, independent positive prognostic factors included DFI, salvage surgery, primary low-grade tumor, and lower pT classification. In contrast, for patients with exclusive distant metastasis, longer DFI (>30 months) and the type of intervention (metastasectomy for oligometastatic disease) were independent prognosticators. Conclusion: Disease-free interval is a key prognostic factor for the residual overall survival after a recurrence event. Primary tumor characteristics were associated with survival outcomes in the loco-regional recurrent setting, but not if the recurrence is at distance. Whenever feasible, salvage surgery for loco-regional recurrence and metastasectomy for oligometastatic disease may be considered in highly selected patients.| File | Dimensione | Formato | |
|---|---|---|---|
|
Prognostic factors ..... in major salivary gland 2026.pdf
solo gestori archivio
Tipologia:
PDF editoriale (versione pubblicata dall'editore)
Licenza:
Tutti i diritti riservati
Dimensione
3.22 MB
Formato
Adobe PDF
|
3.22 MB | Adobe PDF | Visualizza/Apri Richiedi una copia |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
