{
  "abstract": "Background: The 8th edition AJCC TNM (TNM-8) staging framework frequently lacks distinct prognostic discrimination for minor salivary gland carcinomas (mSGCs). This multicenter study was designed to validate the proposed 9th edition (TNM-9) classification, which is tailored to better reflect the biology of these tumors, specifically in oral mSGCs.\n\nMethods: We conducted a retrospective cohort study encompassing 163 patients with primary oral mSGCs treated with curative intent across four tertiary cancer centers. All cases were re-staged using both TNM-8 and the proposed TNM-9 criteria. The primary endpoint was disease-specific survival (DSS). System performance was compared using the Harrell C-index, Akaike Information Criterion (AIC), categorical Net Reclassification Improvement (NRI), and Decision Curve Analysis.\n\nResults: Under the TNM-9 system, survival curves for DSS showed clear and statistically significant separation across all stage groups (p < 0.001). In contrast, TNM-8 failed to significantly differentiate between Stage III and Stage IV outcomes. Advanced TNM-9 stages (IIIA and IIIB) were strong independent predictors of worse DSS. TNM-9 demonstrated superior discriminative ability compared to TNM-8 (C-index: 0.74 vs. 0.68) and a better model fit (AIC: 460 vs. 485). Additionally, TNM-9 correctly reclassified 23% of patients (NRI = 0.23; p = 0.002) and yielded consistently higher clinical net benefit.\n\nConclusion: The proposed TNM-9 classification showed better prognostic discrimination, model fit, and risk reclassification than TNM-8 within this retrospective multicenter cohort. External validation of TNM-9 in larger, geographically diverse cohorts with longer follow-up is required before its routine clinical adoption.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12903-026-09176-8.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Stomatology, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People’s Hospital), Zhengzhou, 450003 PR China",
    "Department of Stomatology, Henan People’s Hospital, Zhengzhou, 450001 PR China",
    "Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450001 PR China",
    "Department of Head Neck, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008 PR China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fang Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuang Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Bingran Du"
    },
    {
      "affs": [
        1
      ],
      "name": "Hongli Chen"
    },
    {
      "affs": [
        2
      ],
      "name": "Wenlu Li"
    },
    {
      "affs": [
        3
      ],
      "name": "Liyuan Dai"
    },
    {
      "affs": [
        3
      ],
      "name": "Qigen Fang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/33wpx3n293txf.bib",
  "cited_by": 0,
  "doi": "10.1186/s12903-026-09176-8",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13715208/",
  "id": "33wpx3n293txf",
  "issns": [
    "1472-6831"
  ],
  "landing_url": "https://doi.org/10.1186/s12903-026-09176-8",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2746|Salivary Gland Tumors Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7172001419",
  "pdf_url": null,
  "pmcid": "PMC13715208",
  "pmid": "42947091",
  "published": "2026-07-31",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/33wpx3n293txf.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:22:34Z",
      "native_id": "PMC13715208",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12903-026-09176-8"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Salivary Gland Tumors Diagnosis and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Real-world multicenter evaluation of the AJCC TNM-9 staging for oral minor salivary gland carcinomas",
  "title_text": "Real-world multicenter evaluation of the AJCC TNM-9 staging for oral minor salivary gland carcinomas",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:34Z",
  "url": "https://research.draconitic.com/paper/33wpx3n293txf",
  "venue": "BMC Oral Health",
  "versions": []
}