Carcinoma ex Pleomorphic Adenoma: Multi‐Institutional Retrospective Cohort Study
Bibliographic record
Abstract
Abstract Objective Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignancy and survival rates vary throughout literature. The primary objectives are to study overall survival (OS), disease‐specific survival (DSS), locoregional recurrence‐free survival (LRFS), and secondarily margin status. Study Design Multi‐institutional retrospective cohort study. Setting Queen Elizabeth II Health Sciences Center (QEII HSC) from 2006 to 2023 and the University of Michigan (UM) from 2017 to 2023. Methods An institutional pathology database (QEII HSC) and parotidectomy database (UM) were used to identify 37 patients with CXPA who underwent surgical resection. Results Most cases were locoregionally advanced with 51% being ≥T3 and 32% being cervical node positive. All cases were treated with surgery, 78% received adjuvant radiation. Overall, 2‐year survival was 82% and 5‐year survival was 61.7%. In univariate analysis, tumor size >4 cm, pathologic nodal stage ≥1, pathologic overall stage 4 disease, lymphovascular invasion, extranodal extension, and positive margins were associated with increased risk of death. In adjusted multivariable analysis, only pathologic nodal stage ≥1 (hazard ratio [HR] 9.474, confidence interval [CI] 1.19‐75.41, P = .034) remained statistically significant. The 2‐year LRFS was 80% and the 5‐year LRFS was 75%. Of the 7 patients with locoregional recurrence, 6 had prior adjuvant radiation, and 4 recurred locally. Multivariable cox models for LRFS were not significant. Conclusion Patients with CXPA that metastasize to the neck have a worse prognosis. LRFS after surgery is 75% with high rates of adjuvant radiation. Further research on prognostic factors of LRFS and adjuvant radiation outcomes is required.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".