{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:02:23Z","timestamp":1789966943473,"version":"4.0.1"},"reference-count":48,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["20\/08431\u20104"],"award-info":[{"award-number":["20\/08431\u20104"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["22\/11861\u20106"],"award-info":[{"award-number":["22\/11861\u20106"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["23\/13091\u20106"],"award-info":[{"award-number":["23\/13091\u20106"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["24\/14439\u20109"],"award-info":[{"award-number":["24\/14439\u20109"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["24\/05212\u20100"],"award-info":[{"award-number":["24\/05212\u20100"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pleomorphic adenoma (PA) is the most common salivary gland tumor, and a subset may recur as recurrent PA (RPA) or progress to carcinoma ex pleomorphic adenoma (CXPA). However, comparative evaluations of their biological behavior and prognostic factors remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize and compare the clinical features, pathological patterns, treatment outcomes, and prognostic factors of PA, RPA, and CXPA over a 20\u2010year period at a Brazilian tertiary referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A retrospective review of 234 cases (148 PA, 23 RPA, 63 CXPA) diagnosed between 2004 and 2024. Analyses included Fisher's exact test and chi\u2010square test for group comparisons and Cox proportional hazards models for overall (OS) and disease\u2010specific survival (DSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PA and RPA mainly affected younger females and presented smaller tumors and shorter clinical evolution than CXPA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). In CXPA, perineural invasion, angiolymphatic invasion, necrosis, recurrence, symptomatology, distant metastasis, and capsular invasion pattern were associated with reduced OS and DSS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This retrospective study demonstrates distinct clinical and pathological profiles across PA, RPA, and CXPA. In CXPA, clinical and histological factors strongly predict survival and should guide risk stratification, therapeutic decisions, and follow\u2010up strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70261","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T04:38:36Z","timestamp":1773808716000},"page":"1923-1937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinicopathological and Prognostic Features of Pleomorphic Adenoma, Recurrent Pleomorphic Adenoma, and Carcinoma ex Pleomorphic Adenoma: A 20\u2010Year Retrospective Analysis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8406-7947","authenticated-orcid":false,"given":"Talita de Carvalho","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Pathology, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"},{"name":"Department of Oral Diagnosis, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3464-8879","authenticated-orcid":false,"given":"Luccas","family":"Lavareze","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"},{"name":"Department of Oral Diagnosis, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5045-6960","authenticated-orcid":false,"given":"Reydson Alcides","family":"de Lima\u2010Souza","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"},{"name":"Department of Oral Diagnosis, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0409-4265","authenticated-orcid":false,"given":"N\u00edvia Castro","family":"Binda","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"},{"name":"Department of Oral Diagnosis, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4217-4629","authenticated-orcid":false,"given":"Carlos Takahiro","family":"Chone","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6193-2686","authenticated-orcid":false,"given":"Alfio Jos\u00e9","family":"Tincani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Surgery, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albina","family":"Altemani","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnosis, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3694-5025","authenticated-orcid":false,"given":"Fernanda Viviane","family":"Mariano","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medical Sciences University of Campinas (UNICAMP)  Campinas Brazil"},{"name":"Department of Oral Diagnosis, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas.2024.102164"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24392"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24228"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(96)80071-0"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.07.1380"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23453"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-020-01231-2"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2018.09.028"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2021.105262"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-009-0139-9"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-016-4253-5"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-013-0454-z"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2021.103352"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2017.00026"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2003.00704.x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12454"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.102279"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980215)82:4<617::AID-CNCR1>3.0.CO;2-I"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2020.06.013"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2016.06.005"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2009.12.011"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-4356(98)90748-3"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.3212"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/hupa.2001.25000"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23638"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2009.09.014"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.14168"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197705)39:5<2209::AID-CNCR2820390540>3.0.CO;2-8"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/02841860802183604"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2020.11.017"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2013.02.012"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(88)90048-3"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1100"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21830"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-015-1887-4"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2016.23.66.5105"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319855376"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2016.1191671"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2009.10.016"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2017.01.004"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2011.03937.x"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24964"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20613"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815607449"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2016.03.037"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26489"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.11.008"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-11-180"}],"container-title":["Oral Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/odi.70261","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/odi.70261","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/odi.70261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T04:13:24Z","timestamp":1789964004000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/odi.70261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":48,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/odi.70261"],"URL":"https:\/\/doi.org\/10.1111\/odi.70261","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/ODI.70261\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ODI.70261\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ODI.70261\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ODI.70261\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ODI.70261\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ODI.70261\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ODI.70261\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1354-523X","1601-0825"],"issn-type":[{"value":"1354-523X","type":"print"},{"value":"1601-0825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"2025-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}