The impact of nodal status in major salivary gland carcinoma: A multicenter experience and proposal of a novel N-classification

Despite differences in oncological behavior, the 8th edition of AJCC TNM staging currently proposes same N-classification for major salivary glands (MSG) carcinoma and squamous cell upper aerodigestive tract. The present study aims to investigate a more reliable definition N-categories MSG carcinoma. A retrospective multicenter was performed, including 307 patients treated primary from 1995 2019. Outcome measures included overall survival (OS), disease specific survival, local, regional, distant recurrence. Survival analysis performed using log-rank test Cox proportional-hazards model. Overall number (ON) largest diameter (LD) nodal metastases, intra-parotid were considered develop three novel proposals N-classification; their performance compared with current Akaike information criterion (AIC), Bayesian (BIC), Nagelkerke pseudo-R2. Intra-parotid nodes, ON LD metastases emerged as prognosticators OS, while extra-nodal extension did not impact on any survival. show satisfactory OS stratification. Three N-classifications developed according metastatic nodes (0 vs 1–3 ? 4) and/or maximum (<20 mm 20 mm). They all showed better accuracy stratification, achieved AIC, BIC pseudo-R2 indices when N-classification. All proposed improved stratification could help defining Their validation assessment an external cohort is needed.