{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:04:10Z","timestamp":1790247850044,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the impact of surgical resection and radiotherapy on overall survival (OS) in clinically distantly metastatic (cM1) major salivary gland cancer (MSGC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The 2006 to 2020 hospital\u2010based National Cancer Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2006 to 2020 National Cancer Database was queried for patients with cM1 MSGC undergoing chemotherapy. Kaplan\u2010Meier and Cox proportional hazards regression models were implemented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 700 patients satisfying inclusion criteria, 219 (37.8%) underwent chemotherapy alone (ie, no local therapy), 159 (27.4%) underwent low\u2010dose chemoradiotherapy (CRT), 56 (9.7%) underwent high\u2010dose CRT, 47 (8.1%) underwent surgical resection\u2009+\u2009chemotherapy, 47 (8.1%) underwent surgical resection\u2009+\u2009low\u2010dose CRT, and 52 (9.0%) underwent surgical resection\u2009+\u2009high\u2010dose CRT; 5\u2010year OS was 10%, 12%, 34%, 25%, 23%, and 28%, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Patients undergoing surgical resection underwent high\u2010dose radiotherapy more frequently (N\u2009=\u200953, 36.1% vs N\u2009=\u200956, 12.9%) but multiple\u2010agent chemotherapy less frequently (N\u2009=\u2009105, 62.5% vs N\u2009=\u2009363, 75.3%) than those not undergoing surgical resection (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.005). Compared with chemotherapy alone, surgical resection\u2009+\u2009chemotherapy (aHR 0.67, 95% confidence interval [CI] 0.53\u20100.86), high\u2010dose CRT (aHR 0.55, 95% CI 0.41\u20100.73), and immunotherapy (aHR 0.49, 95% CI 0.35\u20100.69) were associated with higher OS on multivariable Cox regression (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A minority of patients with cM1 MSGC underwent surgical resection or high\u2010dose CRT. Despite the high rate of PSM, surgical resection was associated with higher OS than chemotherapy alone. High\u2010dose CRT was associated with the highest OS. Definitive local therapy may benefit select patients with cM1 MSGC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70015","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:21:04Z","timestamp":1757686864000},"page":"1182-1197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Definitive Local Therapy in cM1 Major Salivary Gland Cancer"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4031-4932","authenticated-orcid":false,"given":"Matthew","family":"Shneyderman","sequence":"first","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences Washington District of Columbia 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Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"},{"name":"Department of Otolaryngology and Facial Plastic Surgery Cooperman Barnabas Medical Center\u2013RWJBarnabas Health Livingston New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3713-6772","authenticated-orcid":false,"given":"Ghayoour S.","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"},{"name":"Department of Otolaryngology and Facial Plastic Surgery Cooperman Barnabas Medical Center\u2013RWJBarnabas Health Livingston New Jersey 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