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Updated: Jul 26, 2025

Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Comparative impact of grade on mortality across salivary cancers: A novel, unifying staging system
Allen S Ho1,2, Michael Luu1,3, Bonnie L Balzer1,4
1Samuel Oschin Comprehensive Cancer Institute, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Background:
The comparative impact of histologic variants and grade has not been well described.
Methods:
Salivary cancer histologies were profiled using hospital and population-based cancer registries. Multivariable models were employed to assess relationships between histology, grade, and survival.
Results:
On univariate analysis, histologic variants exhibited a wide spectrum of mortality risk (5-year overall survival (OS): 86% (acinic cell carcinoma), 78% (mucoepidermoid carcinoma), 72% (adenoid cystic carcinoma), 64% (carcinoma ex-pleomorphic adenoma), 52% (adenocarcinoma NOS), and 47% (salivary duct carcinoma) (p < 0.001). However, on multivariable analysis these differences largely vanished. Worsening grade corresponded with deteriorating survival (5-year OS: 89% [low-grade], 81% [intermediate-grade], 45% [high-grade]; p < 0.001), which was upheld on multivariable analysis and propensity score matching. Recursive partitioning analysis generated TNM + G schema (c-index 0.75) superior to the existing system (c-index 0.73).
Conclusion:
Grade represents a primary determinant of salivary cancer prognosis. Integrating grade into stage strengthens current staging systems.
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