Lukovic et al reported a simple risk score for predicting more aggressive major salivary gland carcinoma. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Canada, the United States and Brazil.
Patient selection: major salivary gland carcinoma
Parameters from multivariate analysis:
(1) high-risk histology (adenoid cystic carcinoma, salivary duct carcinoma, undifferentiated carcinoma, high-grade adenocarcinoma, high-grade mucoepidermoid, high-grade carcinoma ex pleomorphic adenoma)
(2) pT status
(3) pN status
(4) lymphovascular invasion
(5) microscopic resection margin
Parameter
Finding
Coefficient
high risk histology
no
0
yes
1.2
pT status
pT1 or pT2
0
pT3 or pT4
0.7
pN status
pN0 or pNX
0
PN1 or greater
0.7
lymphovascular invasion
no
0
yes
0.8
microscopic resection margin
negative
0
positve
0.6
total score =
= SUM(coefficients for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4.0
Total Score
Risk Group
5-Year Overall Survival
0 to 2.0
low
92%
> 2
high
48%
Performance:
• The area under the ROC curve is 0.79.
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