{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:39:32Z","timestamp":1789205972851,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The multitude of histological and genetic features of salivary gland malignancies (SGMs) hampers the ability of the doctors\u2019 board to make a clear and quick decision on how aggressively treatment should be initiated. Despite treatment guidelines, it is difficult to determine the appropriate extent and invasiveness of surgery based on preliminary patient data. The aim of this study is to define the factors that have a significant impact on the oncological outcome of SGM treatment and to create an algorithm for finding the combinations of predictors with a particularly unfavorable impact on survival. Methods: A multicenter retrospective analysis was conducted on 2653 patients with salivary gland tumors (SGTs), including 229 with SGMs (parotid 204\/229 = 89.1%; submandibular 25\/229 = 10.9%), treated at seven Polish university departments from 2015 to 2022. All patients, except those with malignant lymphoma, underwent surgery followed by radiotherapy. Seventeen potential survival-impacting variables were analyzed: thirteen preoperative and four surgical specimens. The preoperative group aids in deciding surgical aggressiveness, while the postoperative group supports decisions on adjuvant treatment escalation. The main outcome measures were disease-free survival (DFS) and overall survival (OS). Results: SGMs constituted 8.63% of all SGTs, with 204 (89%) in the parotid and 25 (11%) in the submandibular glands. The average age was 63.38 years, with a male predominance (54%). Clinical and radiological signs of malignancy were reported in 45.4% and 54.6% of patients, respectively, with facial nerve palsy reported in 13%. Postoperative specimens revealed 23 histological types, and R0 resections were achieved in 168\/229 cases (73%). Fifty-six patients (24.5%) died of cancer within five years. Significant survival factors included gender, urban residence, previous chemical and radiation exposure, clinical malignancy symptoms, pT-stage, pN-stage, clinical stage, and resection margins. Conclusions: The prognosis for SGM remains unsatisfactory, which would suggest more aggressive treatment; thus, carefully collected clinical data could support the decision-making process. Significantly worse survival has been demonstrated in the presence of unfavorable clinical factors, so defining new elements of medical history may be a step towards improving treatment outcomes.<\/jats:p>","DOI":"10.3390\/jcm14238527","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8527","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Factors in Salivary Gland Malignancies: A Multicenter Study of 229 Patients from the Polish Salivary Network Database"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3416-7354","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Markowski","sequence":"first","affiliation":[{"name":"Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-3911","authenticated-orcid":false,"given":"Wioletta","family":"Pietruszewska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-0923","authenticated-orcid":false,"given":"Ewelina","family":"Bartkowiak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2571-1824","authenticated-orcid":false,"given":"Bogus\u0142aw","family":"Mikaszewski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Stodulski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Burduk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 87-100 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Radomska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Pomeranian University of Medicine, 70-204 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabela","family":"Olejniczak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Piernicka-Dybich","sequence":"additional","affiliation":[{"name":"Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Wierzchowska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 87-100 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicja","family":"Cha\u0144ko","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Pomeranian University of Medicine, 70-204 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Majszyk","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Bruzgielewicz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5031-1913","authenticated-orcid":false,"given":"Patrycja","family":"Gazi\u0144ska","sequence":"additional","affiliation":[{"name":"Biobank Research Group, PORT Polish Center for Technology Development Lukasiewicz Research Network, 54-066 Wroclaw, Poland"},{"name":"Research Oncology, Division of Cancer Studies, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 9RT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-6352","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Wierzbicka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, 51-124 Wroclaw, Poland"},{"name":"Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland"},{"name":"Institute of Human Genetics, Polish Academy of Sciences, 01-447 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.oraloncology.2011.09.005","article-title":"Salivary gland carcinoma in Denmark 1990\u20132005: Outcome and prognostic factors: Results of the Danish Head and Neck Cancer Group (DAHANCA)","volume":"48","author":"Krogdahl","year":"2012","journal-title":"Oral Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ijom.2009.10.016","article-title":"Salivary gland neoplasms in oral and maxillofacial regions: A 23-year retrospective study of 6982 cases in an eastern Chinese population","volume":"39","author":"Tian","year":"2010","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_3","first-page":"366","article-title":"Salivary gland tumors: A 15-year experience of a univers\u0131ty hospital in TurkeyNorth","volume":"7","author":"Mengi","year":"2020","journal-title":"Clin. Istanb."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Perri, F., Fusco, R., Sabbatino, F., Fasano, M., Ottaiano, A., Cascella, M., Marciano, M.L., Pontone, M., Salzano, G., and Maiello, M.E. (2024). Translational Insights in the Landscape of Salivary Gland Cancers: Ready for a New Era?. Cancers, 16.","DOI":"10.3390\/cancers16050970"},{"key":"ref_5","unstructured":"NCCN Guidelines (2025, June 01). Head and Neck, Version 2.2023. Available online: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1437."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1002\/cncy.22678","article-title":"The 2021 ASCO guideline on the management of salivary gland malignancy endorses FNA biopsy and the risk stratification scheme proposed by the Milan System for Reporting Salivary Gland Cytopathology","volume":"131","author":"Pusztaszeri","year":"2023","journal-title":"Cancer Cytopathol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1200\/JCO.21.00449","article-title":"Management of salivary gland malignancy: ASCO guideline","volume":"39","author":"Geiger","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100602","DOI":"10.1016\/j.esmoop.2022.100602","article-title":"Salivary gland cancer: ESMO\u2013European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"7","author":"Poorten","year":"2022","journal-title":"ESMO Open"},{"key":"ref_9","first-page":"135","article-title":"Salivary Gland Tumors: Limitations of International Guidelines and Status of the planned AWMF-S3-Guideline","volume":"103","author":"Heiland","year":"2024","journal-title":"Laryngorhinootologie"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.21037\/atm-2021-10","article-title":"Editorial for nomograms-based prediction of overall and cancer-specific survivals for patients diagnosed with major salivary gland carcinoma","volume":"9","author":"Asarkar","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3888","DOI":"10.1002\/hed.26890","article-title":"Predicting cancer-specific mortality in patients with parotid gland carcinoma by competing risk nomogram","volume":"43","author":"Luo","year":"2021","journal-title":"Head Neck"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.21037\/atm-21-1725","article-title":"Nomograms-based prediction of overall and cancer-specific survivals for patients diagnosed with major salivary gland carcinoma","volume":"9","author":"Guo","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/hed.2890090204","article-title":"Malignant salivary tumors--analysis of prognostic factors and survival","volume":"9","author":"Soong","year":"1986","journal-title":"Head Neck Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"15127","DOI":"10.1007\/s00432-023-05303-y","article-title":"A novel postoperative nomogram and risk classification system for individualized estimation of survival among patients with parotid gland carcinoma after surgery","volume":"149","author":"Zhu","year":"2023","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1007\/s00405-022-07755-3","article-title":"Prognostic models for estimating survival of salivary duct carcinoma: A population-based study","volume":"280","author":"Zhang","year":"2023","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00405-022-07599-x","article-title":"Clinical value of adjuvant therapy on the prognosis of ductal carcinoma of the major salivary gland: A large-scale cohort study","volume":"280","author":"Zhang","year":"2023","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1002\/ohn.195","article-title":"Prognostic Assessment and Risk Stratification in Patients with Postoperative Major Salivary Acinar Cell Carcinoma","volume":"168","author":"Zhang","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Cai, H.-S., Huang, S.-J., Liang, J.-F., Zhu, Y., and Hou, J.-S. (2022). Clinical Prediction Nomograms to Assess Overall Survival and Disease-Specific Survival of Patients with Salivary Gland Adenoid Cystic Carcinoma. Biomed. Res. Int., 2022.","DOI":"10.1155\/2022\/7894523"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"15330338221117405","DOI":"10.1177\/15330338221117405","article-title":"Nomogram-Based Prediction of Overall and Disease-Specific Survival in Patients with Postoperative Major Salivary Gland Squamous Cell Carcinoma","volume":"21","author":"Li","year":"2022","journal-title":"Technol. Cancer Res. Treat"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3756","DOI":"10.1002\/cam4.3919","article-title":"Competing-risks nomograms for predicting cause-specific mortality in parotid-gland carcinoma: A population-based analysis","volume":"10","author":"Xu","year":"2021","journal-title":"Cancer Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"111199","DOI":"10.1016\/j.ejrad.2023.111199","article-title":"Characterization of parotid gland tumors: Whole-tumor histogram analysis of diffusion weighted imaging, diffusion kurtosis imaging, and intravoxel incoherent motion\u2014A pilot study","volume":"170","author":"Chen","year":"2024","journal-title":"Eur. J. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jasc.2023.08.004","article-title":"Second edition of the Milan System for Reporting Salivary Gland Cytopathology: Refining the role of salivary gland FNA","volume":"13","author":"Rossi","year":"2024","journal-title":"J. Am. Soc. Cytopathol."},{"key":"ref_23","unstructured":"El-Naggar, A.K., Chan, J.K.C., Grandis, J.R., Takata, T., and Slootweg, P.J. (2017). WHO Classification of Head and Neck Tumours, WHO. [4th ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Wierzbicka, M., Bartkowiak, E., Pietruszewska, W., Stodulski, D., Markowski, J., Burduk, P., Olejniczak, I., Piernicka-Dybich, A., Wierzchowska, M., and Amernik, K. (2024). Rationale for Increasing Oncological Vigilance in Relation to Clinical Findings in Accessory Parotid Gland\u2014Observations Based on 2192 Cases of the Polish Salivary Network Database. Cancers, 16.","DOI":"10.3390\/cancers16020463"},{"key":"ref_25","first-page":"1","article-title":"Review and characteristics of 585 salivary gland neoplasms from a tertiary hospital registered in the Polish National Major Salivary Gland Benign Tumors Registry over a period of 5 years: A prospective study","volume":"74","author":"Piwowarczyk","year":"2020","journal-title":"Otolaryngol. Pol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Locati, L.D., Ferrarotto, R., Licitra, L., Benazzo, M., Preda, L., Farina, D., Gatta, G., Lombardi, D., Nicolai, P., and Poorten, V.V. (2023). Current management and future challenges in salivary glands cancer. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1264287"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.bjorl.2020.06.016","article-title":"Prognostic factors and overall survival in a 15-year followup of patients with malignant salivary gland tumors: A retrospective analysis of 193 patients","volume":"88","author":"Filho","year":"2022","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Gregoire, C. (2012). Salivary Gland Tumours. Current Therapy in Oral and Maxillofacial Surgery, Elsevier Saunders.","DOI":"10.1016\/B978-1-4160-2527-6.00056-6"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/0194599815607841","article-title":"Sensitivity, specificity, and posttest probability of parotid fine-needle aspiration: A systematic review and meta-analysis","volume":"154","author":"Liu","year":"2016","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4103\/ams.ams_179_18","article-title":"Parotid gland tumors: 2-year prospective clinicopathological study","volume":"9","author":"Venkatesh","year":"2019","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1159\/000538069","article-title":"Pitfalls in Salivary Gland Cytology","volume":"68","author":"Saoud","year":"2024","journal-title":"Acta Cytol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.anorl.2023.11.005","article-title":"Surgery of major salivary gland cancers: REFCOR recommendations by the formal consensus method","volume":"141","author":"Barry","year":"2023","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_33","first-page":"10","article-title":"Radical Resection of Malignant Tumors of Major Salivary Glands: Is This Possible?","volume":"16","year":"2024","journal-title":"Cancers"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"102697","DOI":"10.1016\/j.ctrv.2024.102697","article-title":"Salivary gland carcinoma: Towards a more personalised approach","volume":"124","author":"Rached","year":"2024","journal-title":"Cancer Treat Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5604\/01.3001.0015.9816","article-title":"Epidemiological and clinical characteristics of 407 salivary glands neoplasms in surgically treated patients in 2010\u20132020","volume":"76","author":"Skulimowska","year":"2022","journal-title":"Otolaryngol. Pol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"8844535","DOI":"10.1155\/2023\/8844535","article-title":"Epidemiological Profile of Salivary Gland Tumors in Southern Iranian Population: A Retrospective Study of 405 Cases","volume":"2023","author":"Ghaderi","year":"2023","journal-title":"J. Cancer Epidemiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.bjoms.2022.11.281","article-title":"Salivary gland tumours: An epidemiological review of non-neoplastic and neoplastic pathology","volume":"61","author":"Mckenzie","year":"2023","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_38","first-page":"512","article-title":"Salivary gland carcinomas\u2014Monocentric experience on subtypes and their incidences over 42 years","volume":"102","author":"Krauss","year":"2022","journal-title":"Laryngorhinootologie"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1007\/s00405-019-05282-2","article-title":"Contemporary treatment patterns and outcomes of salivary gland carcinoma: A National Cancer Database review","volume":"276","author":"Ferrell","year":"2019","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Colombo, E., Van Lierde, C., Zlate, A., Jensen, A., Gatta, G., Didon\u00e8, F., Licitra, L.F., Gr\u00e9goire, V., Vander Poorten, V., and Locati, L.D. (2022). Salivary gland cancers in elderly patients: Challenges and therapeutic strategies. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.1032471"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Zupancic, M., N\u00e4sman, A., Berglund, A., Dalianis, T., and Friesland, S. (2023). Adenoid Cystic Carcinoma (AdCC): A Clinical Survey of a Large Patient Cohort. Cancers, 15.","DOI":"10.3390\/cancers15051499"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1177\/01945998221086845","article-title":"Clinicopathological Predictors of Survival for Parotid Mucoepidermoid Carcinoma: A Systematic Review","volume":"168","author":"Cheng","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1001\/jamaoto.2021.3459","article-title":"Evaluation of Surgical Margin Status in Patients with Salivary Gland Cancer","volume":"148","author":"Hanson","year":"2022","journal-title":"JAMA Otolaryngol. Head Neck Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8527\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:32:05Z","timestamp":1765211525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":43,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jcm14238527"],"URL":"https:\/\/doi.org\/10.3390\/jcm14238527","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}