Search Results (102)

Background: Pleomorphic adenoma is the most common benign salivary-gland neoplasm and frequently affects the minor salivary glands of the palate. Although surgical excision is generally curative, incomplete encapsulation, pseudopod-like extensions, and microscopic tumor deposits may contribute to recurrence, which can occur many years after initial treatment. Recurrent palatal pleomorphic adenoma is uncommon and may present diagnostic and reconstructive challenges. Case Presentation: A 64-year-old man was referred with a painless, slowly enlarging recurrent mass of the right posterior hard palate, six years after excision of a pleomorphic adenoma at another institution. Magnetic resonance imaging and contrast-enhanced computed tomography demonstrated a well-defined enhancing palatal lesion measuring approximately 2.1 × 1.9 × 1.9 cm on MRI and 1.8 × 2.2 × 1.9 on CT, without adjacent maxillary bone destruction or cervical lymphadenopathy. An incisional biopsy was consistent with pleomorphic adenoma. Wide local excision was performed, including the tumor, surrounding palatal soft tissue, and underlying periosteum. The resulting defect was reconstructed using a facial artery musculomucosal flap. The postoperative course was uneventful, with satisfactory flap healing and preservation of speech and swallowing. At six months of follow-up, there was no clinical evidence of recurrence or functional impairment. Conclusions: Recurrent pleomorphic adenoma of the palate may develop several years after primary treatment. Complete surgical excision with tumor-free margins and appropriate reconstruction is essential. Long-term clinical follow-up is recommended because late recurrence and, rarely, malignant transformation may occur. Full article

Background/Objectives: This paper synthesizes and evaluates the potential origins of ectopic salivary gland pathologies in the human nasopharynx. By combining historical reports with an original comparative analysis, this study aims to clarify the precise anatomical and functional status of the proposed tubarial salivary-type glands. Methods: A literature search through December 2025 across major electronic databases identified 84 relevant publications on nasopharyngeal glandular pathologies. The methodological quality in the histomorphological literature was evaluated using the AQUA tool. Concurrently, histological samples were harvested from the inner Eustachian tube opening/torus tubarius region of human, canine, and rodent cadavers and analyzed using histomorphological and immunohistochemical protocols. Results: Most of the literature addressing histologically indicated nasopharyngeal glandular pathology described these findings as controversial, largely overlooking salivary gland origins. The AQUA appraisal identified significant vulnerabilities, showing a high risk of bias in the Study Design domain and yielding moderate inter-rater agreement (κ = 0.435). The empirical morphological study revealed mixed glands with strong mucous predominance in the torus tubarius region of humans and dogs, whereas rodents displayed exclusive PAS positivity within a trabecular stroma. Human samples uniquely demonstrated distinct compartmentalization, duct- and capsule-like formations, and negative α-amylase immunoreactivity. Conclusions: Our pilot empirical evidence, combined with the literature data, suggests a possible pathogenetic link between specific nasopharyngeal neoplasms and the baseline glandular structures of the human torus tubarius. Exhibiting traits of both major and minor salivary systems, the tubarial glands may represent an intermediate structural entity. Furthermore, the animal models utilized do not provide a completely reliable translational framework, highlighting the need for standardized research using fresh human biopsies. Full article

Background/Objectives: Metastasizing pleomorphic adenoma (MPA) is a rare salivary gland tumor characterized by benign pleomorphic adenoma morphology despite regional or distant metastatic behavior. Because most evidence derives from case reports and small series, this systematic review and pooled case-report analysis aimed to summarize published patient-level data and to explore clinicopathologic features, metastatic distribution, treatment, and survival without inferring causal treatment effects. Methods: PubMed, Scopus, Google Scholar, and reference lists were searched for English-language reports published up to 1 August 2025. Eligible reports described primary pleomorphic adenoma and metastatic disease reported as MPA with benign morphology; carcinoma ex pleomorphic adenoma and other malignant pleomorphic adenoma variants were excluded. The primary pooled analysis was restricted to 122 published case-report patients. Institutional cases are presented separately as illustrative cases and were not included in the primary pooled statistical analyses. Unknown, not reported, NA, and unclear values were treated as missing, and denominators are reported. Because only 16 deaths were available, survival analyses were exploratory and no multivariable Cox model was fitted. No formal risk-of-bias or certainty-of-evidence assessment was performed. Results: In the 122 published patients, sex was available for 121 patients and 71/121 (58.7%) were female. Primary tumors most frequently arose in the parotid gland (92/122, 75.4%), followed by the submandibular gland (15/122, 12.3%) and palate/soft palate (10/122, 8.2%). The median interval between primary pleomorphic adenoma and MPA was 12 years (IQR 7–21; range 0–69; n = 118). Metastatic site was reported in 120 patients and was non-mutually exclusive: bone/skeleton and lymph nodes/neck were each reported in 42/120 patients (35.0%), followed by lung/pulmonary metastases in 31/120 (25.8%). Treatment information was available for 98/122 patients. MPA-directed surgery was performed in 86/98 patients with available treatment information (87.75%). The non-surgical cohort received radiotherapy, chemotherapy, palliative treatment, treatment refusal, observation, or other non-surgical strategies. A total of 72 patients had complete covariate data for the reported Cox analyses, including 16 deaths. Estimated 1- and 5-year overall survival were 89.97% and 66.2%, respectively. Surgery was associated with improved overall survival in exploratory Kaplan–Meier comparison (log-rank p = 0.008) and univariable Cox analysis (HR 0.119, 95% CI 0.018–0.810, p = 0.030), but this association should not be interpreted as causal. Conclusions: MPA remains difficult to predict and the available evidence is limited by case-report design, missing data, publication bias, and heterogeneous follow-up. Surgical management may be considered in selected patients when technically feasible and clinically appropriate, but the observed survival association is exploratory and may be influenced by selection bias and disease characteristics. Multicenter registries, standardized reporting, centralized pathology review, molecular characterization, and longer follow-up are needed. Full article

Background/Objectives: Salivary gland tumors account for 2.0–6.5% of all head and neck neoplasms, approximately 70% of which are located in the parotid gland. Preoperative determination of tumor histology is a crucial step in the diagnostic and therapeutic pathway because it guides the choice of surgical technique, affecting the achievement of adequate resection margins and preservation of the facial nerve. Fine-needle aspiration (FNA) cytology is the most commonly used cytologic method. However the complex and heterogenous histologic architecture of salivary gland tumors is associated with a significant proportion of false results. Dynamic contrast-enhanced magnetic resonance imaging (DCE–MRI) is a valuable complementary diagnostic tool that enables noninvasive analysis based on perfusion assessment and tissue characterization. The aim of this study is to evaluate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis of salivary gland tumors and to compare its diagnostic performance with fine-needle aspiration (FNA). Methods: We present a study of 25 patients who underwent DCE-MRI, FNA and postoperative histopathologic examination. Results: Among the 25 patients included, DCE-MRI results were concordant with the postoperative histopathologic diagnosis in 76% of cases, whereas only 36% of positive FNA results correlated with the histopathologic diagnosis. Conclusions: DCE-MRI demonstrates greater correlation with postoperative histopathologic diagnosis compared with FNA. Advantages of DCE-MRI include its noninvasive nature and the ability to image the entire region of interest. Key benefits of FNA are its wide availability and low cost. Selecting the most appropriate preoperative diagnostic modality can positively influence subsequent diagnostic and therapeutic management. Full article

Background/Objectives: Hypoxia-inducible factor 1-alpha (HIF-1α) is a transcription factor that escapes proteasomal degradation under hypoxic conditions, translocates to the nucleus, and activates genes involved in anaerobic glycolysis (e.g., GLUT1 and LDH-A) and vascular endothelial growth factor (VEGF) expression. Through its role in tumor progression, angiogenesis, and metabolic reprogramming, elevated HIF-1α levels have been reported in various malignancies; however, its serum concentration in malignant salivary gland neoplasms remains unexplored. This study aimed to assess serum HIF-1α levels in patients with salivary gland malignancies. Methods: Serum samples were collected from 30 patients diagnosed with malignant salivary gland neoplasms. HIF-1α concentration was determined using an enzyme-linked immunosorbent assay (ELISA). Results: The mean serum HIF-1α concentration was 89.20 ± 44.56 pg/mL. Exploratory analyses demonstrated higher HIF-1α levels in stage III tumors compared with stage II tumors and in high-grade tumors compared with lower-grade lesions. Conclusions: This is the first study to quantify serum HIF-1α levels in patients with malignant salivary gland neoplasms. The findings suggest that while HIF-1α may have potential as a biomarker, its potential as a biomarker of tumor aggressiveness or of malignant salivary gland neoplasms is limited due to high interindividual variability. Further studies with larger cohorts and standardized methodologies are necessary to establish reference values and clarify the clinical significance of HIF-1α in salivary gland malignancies. Full article

Apocrine sweat gland adenocarcinoma is an uncommon feline adnexal neoplasm, and lower-lip involvement is rarely documented. A 14-year-old spayed female Siamese cat was evaluated for a firm 1.3 cm right lower-lip mass at a documented hemorrhagic lesion site. Approximately 1 year earlier, the lesion was fluctuant and superficially erosive to ulcerative; fine-needle aspiration yielded bloody fluid with cytologically nondiagnostic material. The lesion reportedly subsided after empirical treatment, but reassessment, tissue diagnosis, and objective confirmation of resolution were not performed. Cytology of the later same-site mass supported malignant epithelial neoplasia. Contrast-enhanced computed tomography (CT) identified a 12.5 × 13.2 × 16.6 mm rim-enhancing mass without mandibular invasion or distant metastasis; the ipsilateral mandibular lymph node was mildly thickened. Histopathology supported a diagnosis of lower-lip apocrine sweat gland adenocarcinoma with lymphovascular tumor emboli, lymphatic invasion, and nodal metastasis. The diagnosis was supported by superficial dermal/subcutaneous location, adjacent adnexal structures, skeletal-muscle separation from nearby minor salivary glands, epithelial immunoreactivity, periodic acid-chiff (PAS) and Alcian blue findings without distinct intratumoral mucin/mucopolysaccharide-rich material. The cat died without necropsy on postoperative day 87. This case supports tissue-based diagnosis and regional lymph node assessment for suspicious feline lower-lip glandular epithelial lesions. Full article

Background/Objectives: Canalicular adenoma (CaA) is a rare benign salivary gland neoplasm that primarily arises in minor salivary glands. Due to histological overlaps with other benign and malignant tumors, accurate diagnosis remains a challenge. This systematic review aims to comprehensively evaluate the clinical presentation, histopathological features, immunohistochemical (IHC) profiles, treatment modalities, and outcomes of CaA affecting the minor salivary glands. Methods: A systematic search of PubMed, Scopus, ScienceDirect, and Google Scholar was conducted for case reports and case series published in English between 2017 and 2025, following PRISMA guidelines. The review was registered in PROSPERO (CRD42023462417). Eligible studies described canalicular adenoma (CaA) of the minor salivary glands with clinical, histopathological, immunohistochemical, and treatment information. Risk of bias was assessed using the Joanna Briggs Institute tools, and data were synthesized descriptively due to heterogeneity in reporting. Results: Out of 1573 records identified, 23 studies met the inclusion criteria, comprising 44 cases. Canalicular adenoma most frequently affected the upper lip (63.6%), followed by the buccal mucosa and palate. Patients ranged from 29 to 84 years (mean 66 years), with a female predominance. Clinically, lesions presented as slow-growing, painless nodules measuring 2–40 mm. Histopathology consistently demonstrated branching canal-like structures lined by columnar or cuboidal epithelial cells, with immunohistochemistry showing positivity for AE1/AE3, CK7, S-100, and SOX10 and negativity for p63 and α-SMA. Surgical excision was the primary treatment, and recurrence was not reported in any of the 14 cases with documented post-treatment follow-up. Most studies showed moderate to high methodological quality. Conclusions: Canalicular adenoma is a rare benign neoplasm with a strong predilection for older women and for the upper lip. Accurate diagnosis requires correlation of clinical, histological, and immunohistochemical features due to its resemblance to other salivary gland tumors. Surgical management yields excellent outcomes, though multifocality may complicate interpretation of recurrence. Larger multi-institutional studies are needed to refine diagnostic criteria and clarify biological behavior. Full article

Background/Objectives: Hyalinizing clear cell carcinoma (HCCC) and clear cell odontogenic carcinoma (CCOC) are rare clear cell neoplasms with overlapping histopathological features. This study aimed to compare their clinicopathological characteristics, particularly in anatomically challenging sites such as the palate and maxilla. Methods: Three analyses were performed. First, an unpublished series of five HCCC and three CCOC cases was evaluated for diagnostic histopathological features. Second, a PRISMA-ScR-guided literature review of 58 HCCCs and 45 CCOCs restricted to tumours arising in intraoral minor salivary glands, major salivary glands and gnathic bones published between 2000 and 2025 was conducted using PubMed. Third, a sub-analysis compared palatal HCCC and maxillary CCOC (25 vs. 14 cases), integrating literature and unpublished cases. Results: The case series and overall literature review showed that HCCC and CCOC predominantly occurred in adults (mean age, case series: 50.8 years; literature: 56.33 years for HCCC and 61 vs. 54.11 years for CCOC) with a female predilection (case series: 60%; literature: 68%) and generally exhibited clinically indolent behaviour. The site of occurrence, soft tissue (HCCC) versus intraosseous location (CCOC), was the principal distinguishing feature. No marked differences were observed between the two tumours in either the overall literature analysis or the site-specific sub-analysis. However, CCOC at maxillary/palatal sites presented with a higher number of larger lesions and higher number of cases with nodal metastasis compared with HCCC, most probably indicating delayed clinical detection rather than intrinsic aggressiveness of CCOC. Histopathological overlap was considerable; however, diffuse dense hyalinization (4/5), focal glandular differentiation (2/5), mucous-secreting cells (4/5) and salivary gland association (5/5) favoured HCCC, whereas patchy hyalinization (3/3), larger tumour lobules (3/3) and peripheral palisading (2/3) favoured CCOC. Conclusions: HCCC and CCOC demonstrate clinicopathological similarities and shared EWSR1 rearrangement, supporting a close biological relationship. The considerable overlap between these tumours support the hypothesis that CCOC may represent the intraosseous counterpart of HCCC and highlight the importance of integrated clinicopathological assessment and further clarification in future WHO classifications. Full article

Salivary adenoid cystic carcinoma (SACC) is a malignant salivary gland neoplasm characterized by aggressive local invasion and a marked propensity for metastasis. However, the role of MEOX1 in SACC progression remains poorly defined. In this study, we examined the effects of MEOX1 overexpression on the malignant behavior of SACC cells in vitro and in vivo. Human SACC-83 and SACC-LM cells were transduced with lentiviral vectors encoding MEOX1 or an empty vector control, and cell proliferation, migration, invasion, and cell cycle distribution were assessed using CCK-8, wound healing, Transwell, and flow cytometric assays, respectively. RNA sequencing was performed to characterize transcriptional changes associated with MEOX1 overexpression. In vivo, tumor growth was evaluated in BALB/c nude mice bearing subcutaneous xenografts, and pulmonary metastatic colonization was assessed using a tail vein injection model. MEOX1 overexpression reduced the proliferation, migration, and invasion of SACC cells in vitro and increased the G2/M phase fraction. In xenograft models, MEOX1-overexpressing cells formed smaller tumors and showed lower Ki67 staining than control cells. In the experimental lung metastasis model, mice injected with MEOX1-overexpressing cells developed fewer pulmonary metastatic nodules. RNA-seq identified 588 differentially expressed genes associated with MEOX1 overexpression, with enrichment in pathways including cytokine–cytokine receptor interaction, Toll-like receptor signaling, and G protein-coupled receptor signaling. Together, these findings indicate that enforced MEOX1 expression is associated with reduced malignant phenotypes in SACC models and with transcriptomic alterations in pathways related to immune response, G protein-coupled receptor signaling, and DNA damage response. Full article

Background: Malignant salivary gland tumors represent a highly diverse group of neoplasms, their heterogeneity likely arising due to variable origin in different tissue components. Emerging evidence suggests that SOX-2 and EZH-2 play critical roles in salivary gland carcinogenesis, being related to tumor cell stemness potential, along with accelerated tumor progression and unfavorable clinical outcomes. The aim of this study was to assess the association between SOX-2 and EZH-2 expression, survival parameters, and tumors’ pathological characteristics in a group of patients with primary epithelial malignant salivary gland tumors (MSGTs) and to evaluate their value as diagnostic and prognostic markers. Methods: Our study group comprised 104 patients with primary epithelial MSGTs diagnosed in “Sf. Spiridon” County Hospital, Iasi, over a period of fifteen years. Pathological parameters and survival evaluation, along with SOX-2 and EZH-2 immunohistochemistry assessment and scoring, were conducted, and the associations between different parameters were analyzed. Results: High SOX-2 immunoexpression was significantly associated with lymphatic invasion (LY) (p = 0.003), pT stage (p = 0.010), histological tumor type (p = 0.003), and tumor grading (p = 0.037), while high EZH-2 immunoexpression was significantly associated with perineural invasion (PnI) (p < 0.001), vascular invasion (p = 0.038), LY (p = 0.001), tumor grading (p = 0.002), and pathological extranodal extension (pENE) (p = 0.018). The tumors with high SOX-2 and EZH-2 expressions were associated with a reduced overall survival (OS) (p = 0.013 and p = 0.011). Cox regression analysis revealed that pT (HR = 1.826, p = 0.019), LY (HR = 0.318, p = 0.007), and tumor grade (HR = 0.505, p = 0.021) added to high SOX-2 and EZH-2 immunoexpression independently predicted a poor survival outcome (HR = 2.373, p = 0.016 and HR = 2.746, p = 0.015). Conclusions: Our findings suggest that SOX-2 and EZH-2 may serve as biomarkers of aggressive behavior and a poor prognosis in primary epithelial MSGTs, providing potential opportunities for precision-targeted therapies. Full article

Background/Objectives: Malignant salivary gland tumors (MSGTs) are rare, biologically heterogeneous neoplasms in which histopathologic diagnosis and classification are challenging and subject to interobserver variability. Artificial intelligence (AI) approaches using radiologic, histopathologic, and molecular data, including radiomics, deep learning, and biomarker-based models, have been proposed as adjunctive diagnostic tools. This systematic review aimed to identify and critically appraise AI/ML models across radiologic, histopathologic, and molecular domains for distinct diagnostic tasks in MSGTs, and to integrate their diagnostic roles through a functional meta-synthesis. Methods: We conducted a PRISMA 2020-compliant systematic review. Embase, PubMed/MEDLINE, and Scopus were searched from inception to February 2026. Eligible studies developed or validated AI/ML diagnostic or classification models in human salivary gland tumor cohorts and reported extractable performance metrics. Results: From 1265 records, eight studies (1922 participants) met the inclusion criteria, spanning CT/MRI radiomics or deep learning (n = 4), whole-slide histopathology deep learning (n = 3), and DNA methylation-based classification (n = 1). External validation was reported in two CT-based benign–malignant discrimination studies, with AUCs of 0.890 (95% CI 0.844–0.937) and 0.745 (95% CI 0.699–0.791). Heterogeneity in model construction, outcome definitions, and validation strategies precluded meta-analysis. Risk of bias was frequently high in QUADAS-2/PROBAST assessments, driven by retrospective sampling, limited blinding, and analysis-related concerns, while calibration and utility were rarely assessed. Conclusions: AI/ML models for MSGTs demonstrate promising diagnostic performance, particularly for preoperative benign–malignant discrimination, but the current evidence base is limited by heterogeneity, predominantly internal validation, and high risk of bias. The functional meta-synthesis identified three convergent diagnostic domains: malignancy discrimination, histopathologic subtype classification, and molecular/epigenetic taxonomy refinement. Full article

Objective: Mucoepidermoid carcinoma (MEC) is the most common malignant tumour of the parotid gland. This systematic review and meta-analysis aims to evaluate treatment strategies, survival, recurrence, and prognostic factors in primary parotid MEC. Materials and Methods: A systematic review was conducted following PRISMA guidelines. PubMed/MEDLINE, the Cochrane Library, Scopus, and Google Scholar were searched to identify eligible observational studies and clinical trials on primary parotid MEC. Pooled estimates of overall survival (OS), disease-specific survival (DSS), and local, regional, and distant recurrence rates were calculated. Prognostic factors associated with survival and recurrence were analysed. Results: Twenty-one studies involving 7192 patients were analysed. Histologic grade was low in 32.2%, intermediate in 41.8%, and high in 26.1%. Surgical treatment included total parotidectomy (2606 patients) and superficial parotidectomy (1642), with facial nerve preservation achieved in 1993 of 4111 reported cases. Positive margins occurred in 18% of patients, and postoperative radiotherapy was administered in 50%. Mean follow-up was 72.6 months. Pooled OS rates were 100% at 1 year, 90% at 5 years, and 70% at 10 years; DSS was 100% at 5 years and 90% at 10 years. Recurrence rates were 10% local, 0% regional, and 10% distant. High-grade histology, advanced T/N stage, positive surgical margins, and intraparotid lymph node metastasis were associated with poorer outcomes. Conclusions: Parotid MEC generally has favourable short- and intermediate-term outcomes. Based on evidence and institutional experience, we propose a grade-based workflow integrating tumour grade, T/N status, and adverse pathological features to guide surgical extent, elective neck dissection, and adjuvant radiotherapy. Prospective studies with standardized reporting are needed. Full article

Background/Objectives: Head and neck adenoid cystic carcinoma (HNAdCC) is characterized by indolent growth but sustained long-term risk of late recurrence and disease-related mortality. Data describing very long-term outcomes using analytic approaches that explicitly account for competing mortality remain limited. We aimed to characterize late failures, competing causes of death, and clinically interpretable long-horizon risk estimates after primary surgery for HNAdCC. Methods: We performed a retrospective single-center cohort study of patients with HNAdCC treated with curative-intent surgery between 1984 and 2020. Overall survival (OS) and cancer-specific survival (CSS) were estimated using Kaplan–Meier method. Competing risks of disease-related and other-cause death, as well as first-failure patterns, were analyzed using cumulative incidence functions, including a 5-year landmark analysis. Conditional mortality and restricted mean survival time (RMST; τ = 25 years) were additionally assessed. Results: Fifty-seven patients were included (median age 54 years). Median follow-up was 133 months overall and 212 months among survivors. A first failure occurred in 19/57 (33.3%) of patients, with distant metastasis as the most common pattern; 7/19 (36.8%) of failures occurred beyond 5 years. OS at 5, 10, and 25 years was 68.4%, 64.9%, and 37.5%, respectively; corresponding CSS was 78.9%, 74.8%, and 51.7%. At 25 years, cumulative incidence of disease-related death was 41.7%, compared with 20.9% for other-cause death. Older age and advanced T category were independently associated with worse OS, while older age and perineural invasion predicted worse CSS. Among 5-year survivors, conditional risk of disease-related death by 25 years remained 32.7%. RMST analyses demonstrated substantial long-term life-years lost associated with perineural invasion and T3–4 disease. Conclusions: HNAdCC exhibits persistent long-term risk with clinically meaningful late failures and substantial competing mortality over decades. Conditional and RMST-based estimates provide patient-centered measures that support lifelong, risk-adapted surveillance, particularly focused on detection of distant metastases. Full article

Mucoepidermoid carcinoma of the lung is a rare salivary gland-type tumor with heterogeneous clinical behavior and the potential to mimic neoplasms arising in other organs. The purpose of this report is to describe an exceptionally uncommon presentation of pulmonary mucoepidermoid carcinoma manifesting as a breast metastasis in a male patient, a scenario that poses significant diagnostic challenges due to its rarity and its morphological resemblance to primary breast carcinoma. We evaluated the patient through clinical examination, cross-sectional imaging, endobronchial procedures, ultrasound-guided biopsy, immunohistochemistry, and molecular analysis, integrating these data to establish the diagnosis. Imaging revealed a primary lung mass and a second lesion in the left breast infiltrating the pectoralis muscle. Biopsy of the breast mass showed high-grade salivary gland-type mucoepidermoid carcinoma, clinically and radiologically suggestive of pulmonary origin. Because the lesion showed signs of impending ulceration, palliative surgical debulking was performed with good postoperative recovery. The patient subsequently began systemic therapy with gemcitabine. This case underscores the need for careful clinicopathologic correlation when evaluating atypical breast lesions and highlights the diagnostic value of molecular testing in distinguishing primary from metastatic salivary gland-type tumors. Recognizing such rare metastatic patterns is essential for appropriate therapeutic planning. Full article

Background/Objectives: The multitude of histological and genetic features of salivary gland malignancies (SGMs) hampers the ability of the doctors’ 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. Full article