{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:20:07Z","timestamp":1788412807348,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,9,5]],"date-time":"2022-09-05T00:00:00Z","timestamp":1662336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA008748"],"award-info":[{"award-number":["P30CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Background<\/jats:title><jats:sec><jats:label\/><jats:p>Secretory carcinoma (SC) is a rare form of salivary carcinoma that was first described in 2010 and is characterized by <jats:italic>ETV6::NTRK3<\/jats:italic> fusion in most cases. In this large retrospective study, we aimed to identify adverse clinicopathologic factors and propose a prognostically relevant grading scheme for SC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A detailed clinicopathologic review was conducted on 90 SCs from the major and minor salivary glands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age at presentation was 50 years (range: 7\u201393). Sixty\u2010nine (77%) tumours originated from major salivary glands, whereas the remaining 21 involved minor salivary glands.Six cases (7%) had cervical nodal metastasis. Only lymphovascular invasion (LVI) was associated with a risk of nodal metastasis (<jats:italic>P &lt;<\/jats:italic>\u20090.05). The 5\u2010year disease\u2010specific survival and disease\u2010free survival (DFS) were 98% and 87%, respectively. On univariate survival analysis, adverse prognostic factors associated with decreased DFS included minor salivary gland origin, atypical mitosis, high mitotic index, high\u2010grade transformation (HGT), necrosis, nuclear pleomorphism, infiltrative tumour border, fibrosis at the invasive front, LVI, positive margin, and advanced pT stage (<jats:italic>P &lt;<\/jats:italic>\u20090.05). When adjusted for pT stage and margin status, mitotic index, LVI, nuclear pleomorphism, and HGT remained as independent prognostic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We therefore propose a two\u2010tiered grading system for SC. The low\u2010grade SC is defined as those with &lt;5 mitoses \/10 high\u2010power fields and no tumour necrosis, and high\u2010grade SC as those with \u22655 mitoses \/10 high\u2010power fields and\/or necrosis. This proposed grading system can be useful to risk stratify patients with SC for appropriate clinical management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14772","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T03:45:17Z","timestamp":1660707917000},"page":"670-679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Secretory carcinoma of the salivary gland: a multi\u2010institutional clinicopathologic study of 90 cases with emphasis on grading and prognostic factors"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4638-9835","authenticated-orcid":false,"given":"Bin","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-0001","authenticated-orcid":false,"given":"Kartik","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine School of Medicine, Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita","family":"Umrau","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thair A. 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